SOCIO-DEMOGRAPHIC DETERMINANTS;

THALASSIMIC CHILDREN

Abstract

Background: Thalassemic children require regular multiple blood transfusions.
It leads to multiple complications such as blood born infections, iron over load (Haemosidrosis)
and spleen enlargement. Thalassemia transmission to future generations can be prevented
and life of thalassemic children can also be prolonged by proper devoted pre-marital and intra
uterine life management and mitigation of fatal complications. Objectives: The objective of
this study was to assess the socio-demographic determinants of thalassemic children. Study
Design: Descriptive study. Setting: Thalassemia Centre Bahawal Victoria Hospital Bahawalpur.
Period: One year from January 1, 2016 to December 31, 2016. Material and Method: Parents
/guardians of 200 diagnosed children as thalassemic, who were receiving blood transfusions
were selected for interview. The data was collected by Pre- designed Performa to assess sociodemographic
determinants. The data was analyzed to formulate hypothesis. Results: It was
found that maximum number of patients coming for blood transfusion were from 7-9 years and
10 years and above contributing 30% each while 4-6 years were 24% showing that majority of
people seeking for frequent blood transfusion service were over 4 years of age in this area. At
least one thalassemic child death was disclosed by 32 (16%) families. The birth order of the
present thalassemic child as 2nd one was told by 60 (30%) parents. There were 72 (36%) coming
from distance <20 km which shows maximum utility of this center by local area population. It
was found that 104 (52%) belong to poor socio-economic class. There were 188 (94%) children
receiving blood transfusion from teaching hospital blood transfusion center where as 100
(50%) blood donors were unknown people. There were 104 (52%) children who were never
checked for Hepatitis C virus markers while 116 (58%) mothers were illiterate. Regular use of
iron chelating therapy was found to be 8% only. There were 128 (64%) marriages proposed by
parents and 72 (36%) enforced by grand elders resulting 144 (72%) marriages with first cousins.
There were 160 (80%) consanguineous marriages and 188 (94%) without premarital thalassemia
test. There were 142 (71%) new born deliveries without prenatal thalassemia test. Conclusion:
The enforced consanguineous marriages, lack of pre- marital and pre-natal diagnosis, poverty,
illiteracy and lack of iron chelating agent support are the thalassemia problem exaggerating
factors. Reducing magnitude of these problems can mitigate over load and socio-demographic
constraints of thalassemic patients in our country.