غربالگري پيش از ازدواج بتا تالاسمي در شهرستان اروميه در سال 1393: يك گزارش كوتاه

Premarital Screening of Beta Thalassemia in Urmia County of Northwest Iran During 2014: A Short Report

زمينه و هدف: بتا تالاسمي يكي از شايع ترين بيماري‌هاي ژنتيكي در ايران است. امروزه برنامه غربالگري قبل از ازدواج زوجين از نظر ابتلاء به بتا تالاسمي در كشور بسيار مورد توجه است تا از تولد نوزاد مبتلا به تالاسمي ماژور جلوگيري گردد. تولد فرزند مبتلا به تالاسمي ماژور نه تنها مشكلات پزشكي، اجتماعي و اقتصادي زيادي براي بيمار و والدين آنها ايجاد خواهد نمود بلكه بار مالي زيادي نيز بر سيستم بهداشتي و درماني تحميل مي‌‌نمايد. هدف از مطالعه حاضر، ارزيابي برنامه غربالگري پيش از ازدواج بتا تالاسمي در مركز بهداشتي و درماني اقبال شهرستان اروميه در سال 1393 مي‌باشد. مواد و روش‌ها: در اين پژوهش مقطعي، 2341 داوطلبي (2167 مرد و 174 زن) كه در سال 1393جهت انجام آزمايشات روتين غربالگري پيش از ازدواج به مركز بهداشتي و درماني اقبال اروميه مراجعه كردند، مشاركت داشتند. كليه داوطلبين مرد و خانم‌هاي مردان داراي انديكس خون پايين MCV<80 fl] (ميانگين حجم گويچه‌اي)، MCH<27 pg (ميانگين هموگلوبين گويچه اي) و 3/5%

Background and Objective: Beta thalassemia is one of the most prevalent genetic disorders in Iran. Nowadays the premarital screening program for beta thalassemia has brought the highest concern and attention in our country to prevent any child birth affected by the major thalassemia.Thalassemia major leads to serious medical, social, and economic problems for patients and their families, and patient’s care represents a considerable financial burden for the public health budget. The aim of this study was to evaluate the premarital screening program for beta thalassemia in Eghbal Health Center of Urmia during 2014. Materials and Methods: In this cross-sectional study 2341 volunteers (2167 men and 174 women) participated for routine premarital screening in Eghbal Health Center of Urmia. All men’s volunteers and those men’s wives with low blood indices [MCH (mean cell hemoglobin) <27 pg, MCV (mean red cell volume) <80 fl) and HbA2>%3.5], were included. Hematologic parameters were measured by automated cell counter Sysmex KX-21N. Data were analyzed using one-way ANOVA and post Hoc Tukey test. Results: From 2341 subjects, 174 men had MCV<80 fl or MCH<27 pg, so the hematologic indices of their spouses (174 females) were also assessed. 58 women had MCV<80 fl or MCH<27 pg. Among these 58 couples (116 subjects), 98 persons (84 women and 14 men) with iron deficiency anemia, 9 participants (7 women and 2 men) with beta thalassemia and 9 participants (2 women and 7 men) with alpha thalassemia were diagnosed. The frequency of alpha thalassemia and beta thalassemia carriers among men referred to Eghbal Health Center of Urmia was 0.32% and 0.09%, respectively. In beta thalassemia group, HbA2 level showed a significant increase in comparison with thalassemia major and iron deficiency anemia groups (p=0.001). MCH and MCV levels in beta thalassemia patients were significantly lower than in two other groups (p=0.001). Conclusion: Our findings showed that in 2014, the frequency of thalassemia carriers among men referred to the Eghbal Health Center of Urmia is low. However, implementation of thalassemia screening program in the city can effectively prevent the birth of children with thalassemia and prevent unwanted medical costs.