Thalassemia a Major Public Health Issue in UAE

According to Dr Erol Baysal, head of Molecular Genetics Unit at the Genetic and Thalassemia Centre
in Dubai, one in 12 persons in the UAE is said to be thalassemia carrier. And the centre is the only facility in the country that conducts highly specialised tests to detect traits of thalassemia and offer counselling services to patients and their physicians to deal with the emerging results of the tests.

A total of 10,000 people have undergone premarital tests at the centre since the launch of the service in 2005.

When the UAE government made premarital tests mandatory for legalisation of marriages in the country in 2006, health officials said the main aim of the legislation was to protect the country from having children with different types of hereditary diseases, especially thalassemia which has a high prevalence among UAE nationals due to consanguineous marriages.

Dr Baysal feels the numbers of tests carried out are not to be underestimated. “The premarital screening programme is the most important part of our preventive campaign against thalassemia and these tests entail couples, most of whom are young nationals planning to get married,” he said.

“You cannot have a successful preventive programme without prenatal diagnosis which is the new approach to identify the genetic makeup of a foetus and its chances of being a thalassemia carrier or patient.”

As in the case of every autosomal disease, there is a 25 per cent chance for the child of thalassemia carrier parents to become affected. Another 50 per cent of them could be carriers and the rest could be unaffected, normal children.

This principle has been largely found to be correct in the number of cases diagnosed through prenatal tests, as 28 positive cases have been detected in the 115 cases, said Dr Mahmoud Taleb Al Ali, director of the Genetic Centre.

“The benefit of the test lies not only in early detection of the disease in 25 per cent of cases and helping to initiate early treatment,” said Dr Al Ali.

“It also helps 75 per cent of mothers to have social and financial relief by knowing that they will not have an affected child. Once the test is done, those women do not have to basically suffer for nine months thinking that their babies would be affected. That trauma can also be avoided,” he pointed out.

“If the genetic finding tells us that the baby may not require blood transfusion, you are also saving a life from blood transfusion and related complications,” noted Dr Baysal.

Three specialised labs at the centre – one for DNA analysis, another for cytogenetic tests and the third for analysing patients according to their metabolic features – are run by highly trained experts who conduct genetic tests by examining the sub-atomic levels of genes that cause hereditary diseases.

The genotype analysis, which finds out the genetic mutation that causes a disorder and its physical manifestation among patients, helps in determining the specific type of mutations for different types of thalassemia.

Dr Al Ali said the centre is the only facility in the GCC that carries out prenatal genetic test. “We also have the unique distinction of delivering test results on the same day. There are a very few labs in the world which release reports in 24 hours.”

He said the lab results and genetic information passed on to the treating physicians help the latter take a better and speedy decision regarding patient’s treatment.

The doctors said the government could save millions of dirhams by conducting the prenatal tests locally.

“One will have to spend at least Dh100,000 for getting this test done abroad. This can only go high if there are any associated complications. In that case, when you consider the fact that 50 per cent of our patients are UAE nationals, we can say that the government could save at least Dh6 million in two years by offering the service here in Dubai,” said Dr Al Ali.

Dr Baysal said the centre’s goal is to provide the service to every expecting mother who is at risk of delivering a child with thalassemia.