Friday, May 17, 2024

PREVENTION OF THALASSEMIA MAJOR IN PAKISTAN May 8, 2012 (2012-11)

 

Thalassemia Major -A grim picture warranting every step from those who care:- Thalassemia Major is the most common deadly genetic disorder worldwide and consists of a very severe, transfusion dependent, anemia generally presented during the first year of life. It occurs when both parents are Thalassemia carrier. It's particularly associated with people of Mediterranean, Indian subcontinent and Middle East origin. The World Health Organization (WHO) has identified control of haemoglobinopathies, particularly ẞ-thalassemia, in developing world, as a priority.

There are approximately 80000 children suffering from this ailment in Pakistan and further estimated 5000- 9000 children with ẞ-thalassemia are born per year, although no documentary registry is available in Pakistan. The estimated carrier rate is 5-7%, (9.8 million carriers in the total population) with the ethnic distribution of Punjabi- 4.6%, Pathan 5.2%, Sindhi- 4.3%, Baluch-8.0%, Urdu Speaking-5.3%.

With gradual control of malnutrition and communicable diseases, B- thalassemia major patients who earlier died young are now surviving long enough to seek medical attention. In developing countries like Pakistan, this poses an increasing burden for health-care services as adequate blood transfusions with effective iron chelation and bone marrow transplantation is affordable for just a few, therefore, prevention has been demonstrated to be the way forward.

Having a child with Thalassemia major may cost a family an average of 200,000 rupees per year for non curative supportive care i.e. regular blood transfusion and removal of toxic iron from the body by injection or tablets which is higher than average income. Even though optimal supportive care may extend life expectancy to adulthood, this is not accessible to the majority of Pakistani children and most of them die prior to adolescence. In addition, because of frequent transfusions, many children acquire blood borne infection, particularly Hepatitis C.

This extremely depressing and exhaustive ailment is preventable. Countries like Italy, Cyprus, Sardinia and Iran have completely eliminated further birth of Thalassemia children from their countries by creating mass awareness and blood screening etc. Effectiveness of a 20-year control program in Sardinia is evidenced by reduction of the birth rate of thalassemia major from 1:250 live births to 1:4000. Mass awareness, Population screening, genetic counseling, prenatal diagnosis and option of terminating affected pregnancies remain the mainstay strategy to devise an effective Thalassemia control program.

In Pakistan there is dire need to take every step possible to prevent further birth of Thalassemia children. Besides other measures, creating mass awareness in this regard would be of immense value.

Cure2 Children (C2C) foundation is an international nonprofit organization authorized to work in Pakistan. It is made by effected Italian and Pakistani parents and the treating Italian physician of their children. Through their program of "Prevention and cure of Thalassemia major in Pakistan", a 'Bone Marrow Transplant unit in Children hospital, Pakistan Institute of Medical sciences (PIMS) has been established with the collaboration of PIMS. Here, Bone Marrow transplants of 39 Thalassemia children have been performed with the joint efforts of C2C, PIMS and Pakistan Bait-ul-Mal

In continuation of efforts for prevention of Thalassemia major in Pakistan, the C2CF has requested Pakistan Post Department for issuance of a series of Postal stamps. C2C has got these designed and painted by 'Andrea Mancini', a famous artist from Florence, Italy. Issuance of a series of Postage Stamp aimed at creating mass awareness in this regard will go a long way in this humane mission.

On Prevention of Thalassemia major, Pakistan Post is issuing a commemorative postage stamp of Rs.8/- denomination on May 8, 2012.

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