Epidemiological Profile of Haemoglobinopathies in Different Districts of West Bengal: A Retrospective Study

Main Article Content

Oindrila Dhar
Abhishek Sharma
Somdatta Bhaumik https://orcid.org/0000-0001-9004-3378
Anjan Kumar Das

Keywords

Haemoglobinopathy, Beta Thalassemia Trait, Hb E Carrier , HPLC

Abstract

Background: Haemoglobinopathies are autosomal recessive inherited disorders affecting haemoglobin structure or production. Over 1,000 haemoglobin variants have been identified, with carriers often asymptomatic or exhibiting mild anaemia. When both parents are carriers, there is a 25% risk per pregnancy of having a child with a severe form of the disease. Our study aims to (i) describe the epidemiological profile of different haemoglobinopathies, (ii) evaluate the variety of haemoglobinopathies and carriers, and(iii) estimate the prevalence of haemoglobinopathies and carriers.


Methodology: This retrospective cross-sectional study included 5,000 cases obtained from multiple screening camps organized by Ma Sarada Charitable Dispensary & Pathology Centre. All available high-performance liquid chromatography (HPLC) reports with corresponding patient clinical histories and complete blood count results were reviewed. Patients with a history of blood transfusion were excluded from the study to prevent alteration of hemoglobin profiles. Data was extracted and analysed to determine the prevalence and types of haemoglobinopathies in the study population.


Result: Beta thalassemia carrier is the most common haemoglobinopathy (6.36%) detected in West Bengal, followed by HbE carrier. HbE disease, Hb E beta thalassemia, Hb S carrier, Hb S disease, and HPHF trait are the other haemoglobinopathies, also found in this study. Most of the patients are male (11.27%). Among the districts, Beta thalassemia carrier is mostly found in North 24 Parganas, and Hb E carrier is mostly found in South 24 Parganas. Other haemoglobinopathies are also mostly found in North 24 Parganas.


Conclusion: This study highlights a significant prevalence of beta thalassemia and other hemoglobinopathies in the screened population, underscoring the urgent need for widespread screening programs to identify asymptomatic carriers. Early detection through high-performance liquid chromatography (HPLC) can facilitate timely genetic counseling and intervention, thereby helping to prevent disease transmission. Although HPLC interpretation demands specialized training, it remains a reliable and practical screening tool when performed promptly after blood collection to minimize diagnostic errors.

Abstract 24 | PDF Downloads 14 EPUB Downloads 12

References

1. Traeger-Synodinos J, Harteveld CL. Preconception carrier screening and prenatal diagnosis in thalassemia and hemoglobinopathies: challenges and future perspective. Expert Rev Mol Diagn. 2017;17(3):281-291.

2. Livingstone FB. Abnormal hemoglobins in human populations. Chicago: Aldine; 1967.

3. Livingstone FB. Frequencies of hemoglobin variants. New York and Oxford: Oxford University Press; 1985.

4. Weatherall DJ, Clegg JB. Distribution and population genetics of the thalassemias. 4th ed. Oxford: Blackwell Science; 2001. Chapter 6.

5. Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79:704-712.

6. Vachhani NA, Vekariya DJ, Colah RB, et al. Spectrum of ß-thalassemia and other hemoglobinopathies in the Saurashtra Region of Gujarat, India: analysis of a large population screening program. Hemoglobin. 2022.

7. Saeed KMI. Epidemiological features and clinical profile of patients with thalassemia in Kabul, Afghanistan. J Hematol Allied Sci. 2025;5:54-60.

8. Modell B, Darlison M, Birgens H, Cario H, Faustino P, Giordano PC, et al. Epidemiology of haemoglobin disorders in Europe: an overview. Scand J Clin Lab Invest. 2007;67:39-69.

9. Huisman THJ, Carver MFH, Efremov GD. A syllabus of human hemoglobin variants. Augusta, GA: The Sickle Cell Anemia Foundation; 1996.

10. Huisman THJ, Carver MFH, Baysal E. A syllabus of thalassemia mutations. Augusta, GA: The Sickle Cell Anemia Foundation; 1997.

11. Vichinsky E. Hemoglobin E syndromes. Hematology. 2007:79-83.

12. Mahdavi MR, Bayat N, Hadavi V, Karami H, et al. Report of haemoglobin J-Toronto and alpha thalassemia in a family from North of Iran. J Pak Med Assoc. 2012;62(4):396-398.

13. Went LN, Maciver JES. Sickle-cell/haemoglobin-J disease. Br Med J. 1959;2(5144):138-139.

14. Bhat VS, Dewan KK, Krishnaswamy PR. The diagnosis of ɑ-thalassemia; a case of hemoglobin H-ɑ deletion. Indian J Clin Biochem. 2010;25(4):435-440.

15. Joutovsky A, Hadzi-Nesic J, Nardi MA. HPLC retention time as a diagnostic tool for hemoglobin variants and hemoglobinopathies: a study of 60,000 samples in a clinical diagnostic laboratory. Clin Chem. 2004;50(10):1736-1747.

16. Steinberg MH. Sickle cell anemia, the first molecular disease: overview of molecular etiology, pathophysiology, and therapeutic approaches. Sci World J. 2008;8:1295-1324.

17. Steinberg MH, Forget BG, Higgs DR, Nagel RL. Disorders of hemoglobin. 2nd ed. Cambridge: Cambridge University Press; 2009.

18. Bain BJ, editor. Haemoglobinopathy diagnosis. 2nd ed. London: Wiley; 2006.

19. Okawa T, Tsunekaxa S, Senio Y, Hamada Y, Oiso Y. Deceptive HbA1c in a patient with pure red cell aplasia. Lancet. 2013;382:382-386.

20. Sharma P, Das R. Cation-exchange high-performance liquid chromatography for variant hemoglobins and HbF/A2: what must hematopathologists know about methodology? World J Methodol. 2016;6:20-24.

21. Joutovsky A, Hadzi-Nesic J, Nardi MA. HPLC retention time as a diagnostic tool for hemoglobin variants and hemoglobinopathies: a study of 60,000 samples in a clinical diagnostic laboratory. Clin Chem. 2004;50:1736-1747.

22. Raghothama C, Rao P. Degradation of glycated haemoglobin: role of erythrocytic proteolytic enzymes and oxidant damage. Clin Chim Acta. 1997;264(1):13-25.

23. Mondal SK, Mondal S. Prevalence of thalassemia and hemoglobinopathy in eastern India: a 10-year high-performance liquid chromatography study of 119,336 cases. Asian J Transfus Sci. 2016;10(1):105-110.

24. Singh V, et al. Prevalence of hemoglobinopathies using high-performance liquid chromatography as diagnostic tool in anemic patients of tertiary care center of Western India. Asian J Transfus Sci. 2024;18(2):257-263.

25. Jain BB, Roy RN, Ghosh S, et al. Screening for thalassemia and other hemoglobinopathies in a tertiary care hospital of West Bengal: implications for population screening. Indian J Public Health. 2012;56:297-300.

26. AlQarni AM, et al. Diagnostic test performance of the Mentzer index in evaluating Saudi children with microcytosis. Front Med. 2024;11:1361805.

27. Zafar M, Tabassum A, Cheema QA, et al. Role of red cell distribution width and Mentzer index in differentiating iron deficiency anemia from anemia due to ß-thalassemia trait. J South Asian Fed Hematol Immunol.2019; 11(5):297-300.

28. Weatherall DJ. Hemoglobinopathies worldwide; present and future. Curr Mol Med. 2008;8:592-599.

29. Sachdev R, Dam AR, Tyagi G. Detection of Hb variants and hemoglobinopathies in Indian population using HPLC: report of 2600 cases. Indian J PatholMicrobiol. 2010;53:57-62.

30. Rao S, Kar R, Gupta SK, Chopra A, Saxena R. Spectrum of haemoglobinopathies diagnosed by cation exchange-HPLC and modulating effects of nutritional deficiency anaemias from north India. Indian J Med Res. 2010;132:513-519.