Epidemiology of Thalassemia in Papua New Guinea: A Systematic Review Nichola Noelle Kotale
Faculty of Health Science, Universitas Jenderal Sudirman
Abstract
ABSTRACT
Background: The thalassemias are a large group of autosomal recessive disorders which amounts to 90% of 300,000 - 400,000 of the hemoglobin disorders, in babies born in Low-Middle Income Countries (LMICs). Papua New Guinea (PNG) lies in the thalassemia belt, where thalassemia is endemic, and has evidence of thalassemia dating back to the 1950s.
Objective: This systematic review aimed to assess the epidemiological status of thalassemia in PNG.
Method: A systematic search was conducted in MEDLINE/PubMed (National Library of Medicine), Google Scholar, Science Direct, Cochrane, and Episteonikos. Relevant observational studies reporting the epidemiology of thalassemia among the PNG population were selected. Data on the prevalence and frequency were extracted. The quality of the retrieved studies was assessed according to the Newcastle-Ottawa Quality Assessment Scale.
Results: A total of 15 studies were selected based on eligibility criteria. Five studies reported the prevalence of thalassemia and five studies reported the frequency of thalassemia in relation to malaria. Two studies describe the quality of life of thalassemia patients while reporting frequency and three studies investigated the causes of anemia, in which thalassemia was a constituent, presented in frequency. Of the 8323 study samples, 3716 participants presented with thalassemia genes. Almost 98% were alpha-thalassemia and less than 6% were beta-thalassemia. Thalassemia genes were detected in both children and adults without variations in age. Alpha thalassemia was common in lower altitudes where malaria was common. Beta thalassemia was also common in coastal areas, with a few genes detected in the lower Highlands of PNG.
Conclusion: Most of these studies date back more than twenty years. The epidemiological status of thalassemia remains unclear. With no proper screening programs and diagnosis of thalassemia in PNG, the extent to which thalassemia prevails remains obscured. There needs to be more public education and awareness of thalassemia. It is recommended that a national thalassemia screening and counseling program be implemented in the country.
Keywords: Thalassemia, Papua New Guinea, Cooley^s Anemia
