Impact of a national beta-thalassemia carrier screening program on the birth rate of thalassemia major.
BACKGROUND
In Taiwan, the prevalence of beta-thalassemia trait is at least 1.1%. The Taiwan government initiated a National Screening Program in 1993. Herein we examine the differences before and after the initiation of this program.


METHODS
Data consisting of the total number of patients and the birth prevalence beta-thalassemia major were collected. Ninety-one patients with transfusion-dependent thalassemia treated in our hospitals were included for analysis. DNA analysis was performed for 86 patients.


RESULTS
In Taiwan 361 patients exist. The birth prevalence of per 100,000 births was 5.6% in 1994 and declined to 1.21 in 2002. Fourteen patients were born after the program's initiation. DNA analysis of them revealed a new mutation (IVS-1-5 (G-C)), which was introduced through an inter-racial marriage. Otherwise, the remainder was the common beta-thalassemia mutations found in Taiwan.


CONCLUSIONS
Despite how successful the National Screening Program is, a few doctors still failed to detect parents at risk. In addition, we are concerned about the emerging problem of the increase of interracial marriages where parents may not have appropriate screening. Hence, postgraduate education programs for physicians, health education for the general population, and timely screening of inter-racial marriage should become a priority.
Chern
Jimmy P S
JP
Department of Medicine, Tao-Yuan General Hospital, Department of Health, Taiwan.
Lin
Kai-Hsin
KH
Su
Yi-Ning
YN
Lu
Meng-Yao
MY
Jou
Shiann-Tarng
ST
Lin
Dong-Tsamn
DT
Wang
Shih-Chung
SC
Lin
Kuo-Sin
KS
D002648:Child; D002675:Child, Preschool; D005260:Female; D006580:Genetic Carrier Screening; D005820:Genetic Testing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009154:Mutation; D009313:National Health Programs; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015995:Prevalence; D015397:Program Evaluation; D013624:Taiwan / Q000453:epidemiology; D017086:beta-Thalassemia / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*