Population Screening for Thalassemia In West Bengal with a Goal to Make Zero Thalassmia Growth

India is in the Thalassemia belt of the world. Presently prevalence of Thalassemia carrier in India is 3.7% of its total population. Annual increment of Thalassemia carrier is 50,000. Both Alpha and Beta Thalassemia are found in West Bengal, a state in Eastern part of India. Beta Thalassemia is most common in West Bengal. Annual Increment of beta carrier is 2000–2500. With a motivation to make zero Thalassemia growth in West Bengal we started this program in 2005 taking Cyprus as an example. We regularly arranged camps in different districts and rural areas of West Bengal. To aware the general people seminars on Thalassemia were organized. Usually we took help from Principals of colleges & schools, Presidents of club, Gram Pradhans, Priests, Fathers & Celebrities etc.

Duration of this screening study is from January 2005 to July 2010. Interested people came for thalassemia screening irrespective of cast & creed. Screening procedure consisted of the following steps. NESTROF test for all individuals was done on the spot which was followed by CBC and HPLC, done in the Laboratory. Finally to reveal different mutations in b globin gene and deletions in alpha globin gene, ARMS-PCR and gap PCR were performed respectively with the DNA of the suspected individuals.

For thalassemia carrier screening we had organized 122 camps in different rural as well as urban areas of West Bengal from January 2005 to July 2010. Total number of individuals screened is 29,350 (Male: 18197, Female: 11153). 24% individuals were found positive from NESTROF test and 28% has doubtful CBC. NESTROF positive and doubtful CBC samples were undergone HPLC test. Finally, 13% individuals were found beta carrier. In two camps at north Bengal we have collected about 278 samples having positive NESTROFT value and having abnormal CBC values (MCV < 80 fl, MCH< 27 pg, MCHC > 30 g/dl, RDW > 13%) were tested for HPLC. HbA₂ values were found in the normal range. DNA analysis by gap PCR revealed that approximately 47% of them are alpha Thalassemia carrier, 32% having 3.7 kb deletion, 11% having 4.2 kb deletion and 4% other deletions.

As the percentage of thalassemia carrier in West Bengal is very high we have to take concrete steps to control the disease from the Government level. From our part we are screening the boys and girls at marriageable age and advising them not to marry between two carriers.

No relevant conflicts of interest to declare.