Thalassemia in the United Arab Emirates: Why it can be prevented but not eradicated

Abstract

Thalassemia is a genetic blood disorder that causes abnormal hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen and is made of two proteins from four α-globin genes and two β-globin genes. A defect in one or more of these genes causes thalassemia. The treatment of thalassemia mostly depends on life-long blood transfusions and removal of excessive iron from the blood stream. Such tremendous blood consumption puts pressure on the national blood stock in many countries. In particular, in the United Arab Emirates (UAE), various forms of thalassemia prevention have been used and hence, the substantial reduction of the thalassemia major population has been achieved. However, the thalassemia carrier population still remains high, which leads to the potential increase in the thalassemia major population through carrier-carrier marriages. In this work, we investigate the long-term impact and efficacy of thalassemia prevention measures via mathematical modeling at a population level. To our best knowledge, this type of assessment has not been done before and there is no mathematical model that has investigated such a problem for thalassemia or any blood disorders at a population level. By using UAE data, we perform numerical simulations of our model and conduct sensitivity analysis of parameter values to see which parameter values affect most the dynamics of our model. We discover that the prevention measures can contribute to reduce the prevalence of the disease only in the short term but not eradicate the disease in the long term.

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

“…Furthermore, consanguinity is prevalent in the GCC region, which increases the risk of genetic-related health outcomes such as thalassemia [124] that can negatively impact pregnancy and child birth [125]. However, early intervention and management can minimize the negative consequences of these conditions on the delivery of the child and their prognosis.…”

Oral manifestations and dentofacial anomalies in β‐thalassemia major children in Dubai (UAE)

“…Cochran sample size calculation was dependent on the proportion of dental caries among β -thalassemia patients from previous studies in a comparable community in the region (82.6% in age group 6-9 and 78.6% in age group [12][13][14][15][16][17][18]. The data used in this study were published by Hattab et al 8 This yielded a minimum of 35 thalassemia patients required.…”

“…At a population level, it was concluded that the prevention measures can only contribute to the reduction of the prevalence of the disease in the short term but not eradicate the disease. 14 The prevalence of dental caries and other orofacial conditions in thalassemia patients is not adequately reported in the UAE Emirati population and neighboring countries.…”

“…The UAE was successful in reducing the numbers of thalassemia major population. However, the thalassemia carrier population still remains high, which leads to a potential increase in the thalassemia major population through carrier–carrier marriages . A recent UAE study investigated the long‐term impact and efficacy of thalassemia prevention measures via mathematical modeling.…”

“…A recent UAE study investigated the long‐term impact and efficacy of thalassemia prevention measures via mathematical modeling. At a population level, it was concluded that the prevention measures can only contribute to the reduction of the prevalence of the disease in the short term but not eradicate the disease …”