Drive to eradicate thalassaemia on in Saurashtra

rajkot: prevention is the only cure for thalassaemia. this is the aim experts have adopted to eradicate the single most common genetic blood disorder in gujarat, particularly saurashtra. a high-prone zone of beta thalassaemia major, the most severe form of the disorder, the region is known to have at least 11 per cent of its population afflicted by the disease.the figure may be misleading considering the fact that many patients are carriers (thalassaemia minor) but unaware of their status. although thalassaemia is prevalent world-wide, it is the single most common genetic disorder affecting all ethnic backgrounds and geographic regions in the indian subcontinent. the highest frequency of the thalassaemia trait in the country is reported in gujarat. the communities at high risk are lohanas, sindhis, kutchi bhanushalis, muslims and harijans. "our aim is to eradicate thalassaemia major from saurashtra through mass screening and proper counselling," says dr sushmita dave, director of the thalassaemia prevention and control campaign. "there is no effective treatment for this disease till now, but by mass screening and proper genetic counseling we can prevent the birth of every single thalassaemia major child," she adds. a thalassaemia major child can be born if both the mother and father are thalassaemia minor. if only one parent is thalassaemia minor the offspring may be normal or at the most a carrier. as a first step towards eradication, the indian medical scientific research foundation and saurashtra university joined hands for identifying thalassaemia minor students in the 149 colleges affiliated to the university through a free test programme last month. the university has made it mandatory for its 1.60 lakh students to undergo thalassaemia test for being eligible to take their annual examination in march-april 2002. "we had screened nearly 35,000 students in 1993 at thalassaemia camps. but when we made the test voluntary and not mandatory only 250 students got themselves tested the following year. hence, we have decided to make it mandatory once again," says dr dave. according to dr gupta of the rajkot voluntary blood bank and research centre, who has been instrumental in carrying out the mass screening test in the colleges, so far 28,193 students have been tested in porbander, amreli, junagadh and parts of rajkot. in the first round, students are subjected to a test called nestroft, which identifies those with a low haemoglobin level or anaemia. "this test is inexpensive and takes hardly five seconds. we distribute iron supplements to the anaemic students and return for the second test after a coupld of months. if the student is anaemic he/ she is subjected to the second test or chromatography which confirms whether he/ she is a thalassaemia minor or not," he explains. but his team is faced with a piquant situation. "at the outset we thought we would be educating the students about thalassaemia, but we have ended up lecturing them on the importance of a balanced diet as a majority of them (both boys and girls) are anaemic," he says. however, he hopes to complete the process of identification 'within six months positively'. but noted paediatrician manorama mehta believes this approach is faulty considering the fact that most of our children do not get a balanced diet. "my suggestion is that we should first distribute iron supplements among the students and then conduct the nestroft to eliminate those who are anaemic and not thalassaemia minor." indrani jani, in charge of counseling, says "students found to be thalassaemia minor will be counselled so that tomorrow when they decide to get married and plan a family they are aware and would want to find out if their partner is also a thalassaemia minor. in case the husband is also a carrier of the disorder, the wife must make it a point to go in for a pre-natal check-up in the second month of pregnancy to determine whether their child is a thalassaemia major or not." dr mehta says obstetricians and paediatricians of the region should make it a point to screen their patients for thalassaemia in addition to other regular tests. they should make enquiries of the family history of the thalassaemia patient so that the birth of a thalassaemia major child in that family is ruled out. dr dave adds: at least by carrying out these tests in colleges we are educating and motivating 1.60 lakh students and their families. i think the future is bright. why do you forget we were successful in eradicating small pox despite social resistance. and, thalassaemia is not a disease in the first place."