2023-08-27 06:11:00
Thalassemia: A Silent Threat in Thailand
Thalassemia, a type of anemia caused by abnormal red blood cells, has become a pressing concern in Thailand. It is an inherited disease that occurs when individuals inherit abnormal genes from their parents. Recent statistics reveal a staggering number of thalassemia carriers in the country, with almost 500,000 Thai people affected. In fact, more than 18 million people in Thailand have been identified as thalassemia carriers, highlighting the close proximity of this condition.
Thalassemia manifests itself in two distinct groups of patients. The first group consists of carriers who appear healthy in every way but carry the latent genetic trait. Although they have no apparent symptoms, they can pass on the abnormality to their offspring. A simple blood test can confirm if an individual is a carrier of thalassemia.
The second group encompasses individuals who exhibit obvious symptoms of thalassemia, such as paleness, yellow eyes, fatigue, bloated stomach, and enlarged liver and spleen. These patients require regular blood transfusions, usually on a monthly basis. Shockingly, 30-40% of the Thai population, equivalent to 18-24 million people, are carriers of thalassemia. Among them, approximately 1% (630,000 people) suffer from severe thalassemia, which poses a danger to both mother and child during pregnancy.
In severe cases, blood transfusions become a necessity to suppress abnormal blood formation. The high transfusion approach is commonly used in pediatric patients with severe thalassemia, ensuring their healthy growth as they age. However, this method leads to excessive iron accumulation in the body and necessitates the addition of iron pills to counteract the effects. Another approach, known as low transfusion, involves providing blood only when the patient becomes exhausted due to paleness resulting from their condition.
Thalassemia patients face the risk of iron overload from the blood they receive and excess iron absorption from the gastrointestinal tract. This iron accumulation can cause severe complications such as heart failure, liver damage, cirrhosis, and even diabetes. Regular assessments are essential to monitor iron overload and mitigate potential complications.
To combat thalassemia, iron chelation pills may be necessary in cases where serum ferritin levels exceed 1,000 ng/ml, patients have been receiving blood transfusions for over a year, or they have received blood 10-20 times. In severe cases requiring splenectomy, anti-infectious vaccinations are recommended at least two weeks before the procedure to prevent infection.
Hematopoietic stem cell transplantation stands as the only method capable of curing 75-92% of thalassemia cases. However, this treatment option carries a high cost and potential risks. Suitable candidates for this method are pediatric patients with severe thalassemia who have siblings or donors with compatible HLA or histological profiles. The likelihood of finding a match ranges from 1 in 4 for siblings to 1 in 10,000 to 1 in 100,000 for unrelated donors.
Thalassemia, while threatening, remains treatable through various measures. Patients are urged to consume a balanced diet, avoiding iron-rich foods such as blood and liver. Iron-containing drugs and vitamins should be discontinued, and patients should receive full vaccinations. Exercise is recommended, but with caution to avoid excessive impact. Smoking and alcohol consumption are strongly discouraged, while regular dental check-ups are necessary to prevent tooth decay. High fever should be promptly assessed by a doctor due to the increased risk of serious infections. Strict adherence to prescribed folic acid intake is crucial.
For couples planning to have children, it is essential to undergo health check-ups before conceiving if both spouses are carriers of thalassemia. The risk of having a child with thalassemia disease is 25% in such cases. Consulting a doctor for prenatal diagnosis or considering artificial insemination can aid in ensuring a healthy pregnancy and birth.
The information presented in this article is derived from Phayathai Hospital and the Ministry of Public Health. Visual content is provided by Shutterstock.
In summary, thalassemia is a silent threat in Thailand affecting millions of people. Awareness, early detection, and proper management are key to reducing the impact of this inherited condition.]
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