Thalassemia Phenotypes and Associated Mortality among Yemeni Patients: A Single-Center Retrospective Analysis

Abstract

Objective: To retrospectively analyze thalassemia phenotypes and associated mortality among Yemeni patients seeking healthcare in Sana’a city, Yemen.

Methods: This retrospective, cross-sectional study was conducted in the medical center of Yemen Society for Thalassemia and Genetic Blood Disorders (YSTGBD) in Sana'a city from January 2010 to December 2016. Data about gender, age, governorate of origin, type of thalassemia and thalassemia-related mortality were retrieved from the records of 496 thalassemia patients. Data were then entered into an Excel spreadsheet, cross-checked for accuracy and presented as frequencies and proportions. Factors associated with deaths among thalassemia patients were analyzed using chi-square or Fisher’s exact tests.

Results: A total number of 496 patients attended the medical center of YSTGBD in Sana’a city in the period from January 2010 to December 2016. The majority of thalassemia patients were males (57.9%), and approximately half of the patients were aged 10 years or younger with a comparable proportion to those older than 10 years. Most thalassemia patients had β-thalassemia (92.7%), while 7.3% had α-thalassemia. The majority of patients were from Hajjah governorate (16.5%) followed by those from Sana'a (13.1%) and Amran (11.9%), while lower proportions ranging from 0.2% to 8.1% were recorded for patients from other governorates. Thirty out of the total attending thalassemia patients died, and mortality was significantly associated with recurrent transfusions of whole blood but not with the gender and age of the patients or thalassemia phenotype.

Conclusions: The majority of thalassemia patients seeking healthcare in Sana’a city suffer from thalassemia, where males represent more than half of them and the patients are almost equally distributed in relation to the cut-off age of 10 years. The mortality incidence among Yemeni thalassemia patients seeking healthcare is lower than that reported elsewhere in the world, and mortality was significantly associated with recurrent blood transfusions. Further studies to identify the genetic abnormalities associated with thalassemia are recommended together with the need for the launch of a national center for counseling, research and supervision of voluntary activities related to thalassemia and genetic blood disorders in Yemen.

Keywords: Thalassemia, Phenotype, Mortality, Yemen