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

PLoS One. 2017 Jan 30;12(1):e0170485. doi: 10.1371/journal.pone.0170485. eCollection 2017.

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.

MeSH terms

  • Computer Simulation
  • Consanguinity
  • Disease Eradication*
  • Educational Status
  • Female
  • Heterozygote
  • Humans
  • Male
  • Mass Screening
  • Models, Theoretical
  • Population Dynamics
  • Prevalence
  • Thalassemia / diagnosis
  • Thalassemia / epidemiology*
  • Thalassemia / prevention & control*
  • United Arab Emirates / epidemiology

Grants and funding

SK is supported in part by the United Arab Emirates University Start-up grant with No. 31S106 and AT by the United Arab Emirates University Start-up grant with No. 31S105 with www.uaeu.ac.ae. The funder had no role in study design, analysis, decision to publish, or preparation of the manuscript.