Thalassemia Around the World: Egypt

November 10, 2009At the recent 9th Cooley’s Anemia Symposium, representatives from CAF had the pleasure of meeting Dr. Mona Hamdy Mahmoud, Associate Professor of Pediatric Hematology at Cairo University in Egypt. Dr. Mahmoud, who has worked in the thalassemia unit for 15 years, agreed to answer some questions about thalassemia in Egypt.

CAF: Approximately how many people in Egypt have thalassemia?

More information on hemoglobinopathies in Egypt is available by clicking here.
(Link takes you to slides for a presentation given by Prof. Amar El-Beshlawy. for the 1st Pan-Middle East Conference on Haemoglobinopathies.)

Dr. Mahmoud: In Egypt there are 10,000 registered thalassemia cases and more than 20,000 non-registered cases. 95% are beta thalassemia major; 5% are thalassemia intermedia or hemoglobin H disease. We do not have any cases of e beta thalassemia. Trait carrier rate ranges between 5.5%to >9.5% based on a study carried out on 5000 normal candidates in 5 governorates in Egypt.

Can you tell us a little about treatment for thalassemia in Egypt?

Typical treatment for a thalassemia patient in Egypt includes blood transfusion and chelation. Desferal is the most common chelating agent, but both deferiprone and Exjade are also available. As elsewhere, when patients are well transfused and well chelated, they have a good prognosis. The median age of patients is 25 years. Barriers to treatment include the availability of blood in free-of-charge thalassemia centers. Adequate chelation is financially unaffordable for many patients.

Tell us a little about your thalassemia center.

Our hematology unit was established by Prof. Amar El-Beshlawy 35 years ago. There are 3000 thalassemia patients in my center and 500 sickle and sickle beta patients. We treat both pediatric and adult thalassemia patients.

How would you rate the level of awareness of thalassemia and thalassemia trait among the general population in Egypt?

The level of awareness of thalassemia among the Egyptian population is average. The carrier rate in Cairo is more than 9.5%, while in governorates of upper Egypt it ranges from 5.5% to 7.5%. There is no resistance to being treated for thalassemia trait, but awareness needs to be encouraged by the mass media and there is a need for a national screening program. There are programs in the big centers which include premarital and prenatal screening.

What is the biggest challenge facing the thalassemia community in Egypt?

The biggest challenge in Egypt is that we have the medical experience but lack the adequate financial support. The Egyptian Thalassemia Association has a very wide range of medical and social activities for Egyptian thalassemics but lacks the fund for medical research in thalassemia. (Prof. El-Beshlawy is the head of the association, and I am a board member ).

What else should we know about thalassemia in Egypt?

There is a very high prevalence of hepatitis C virus among our patients; 74% are positive by PCR.

CAF thanks Dr. Mahmoud for sharing this information about thalassemia and contributing to our understanding of thalassemia around the world.

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