[Genetic hemoglobin diseases. Prevention at centers for family planning and education of maternal-child protection in Marseille].
OBJECTIVE
Diseases due to inherited hemoglobin disorders represent serious medical, social, and economic problems in the region of Marseille. The only effective treatment for such diseases is allogenic bone marrow transplantation. About 200 patients with either thalassemia, sickle cell or sickle cell-beta thalassemic diseases are regularly seen in local hospitals. All of these patients come from parts of the world where genetic hemoglobin disorders are endemic.


METHODS
At this time, the only approach for reducing the number of affected children born is preventive. This depends upon education, the detection of carriers, genetic counselling and sometimes, prenatal diagnosis. We have organised a program of prevention supported by a grant from the DISS (Direction des Interventions Sociales et Sanitaires) in the context of visits made to the PMI (Prevention Maternelle et Infantile). This initiative concerns women presenting for consultations for three reasons: for a prenuptial check-up, for a pregnancy, and for prescription of contraceptives.


RESULTS
In each of these three situations a check-up is obligatory and, for natives of countries where hemoglobin disorders are common, a hemoglobin test is recommended. If this test reveals an abnormality, the partner or husband is also tested, if he is willing. Couples who are both carriers are given genetic counselling.


CONCLUSIONS
This preventive initiative has yielded valuable results so we hope to follow-up on the approach and extend it to other centers. Such screening, based upon the geographic origins of patients, can be implemented in the course of a consultation by any doctor.
Lena-Russo
D
D
Faculté de Médecine Timone, Centre d'Enseignement et de Recherche en Génétique médicale, Marseille.
Erny
N
N
Serradimigni
F
F
Badens
C
C
Aubinaud
M
M
Merono
F
F
Paolasso
C
C
Mattei
J F
JF
Giraud
F
F
D000755:Anemia, Sickle Cell / Q000235:genetics / Q000517:prevention & control*; D001797:Blood Protein Electrophoresis; D005193:Family Planning Services / Q000193:education*; D005260:Female; D005602:France; D006288:Health Planning Organizations; D006445:Hemoglobin C Disease / Q000235:genetics / Q000517:prevention & control*; D006453:Hemoglobinopathies / Q000235:genetics / Q000517:prevention & control*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008430:Maternal-Child Health Centers; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012307:Risk Factors; D017086:beta-Thalassemia / Q000235:genetics / Q000517:prevention & control*
D006454:Hemoglobins
Maladies génétiques de l'hémoglobine. Prévention dans les centres de planification et d'éducation familiale de la protection maternelle et infantile à Marseille.