Large scale screening for haemoglobin disorders in southern Vietnam: implications for avoidance and management.
O'Riordan S., Hien TT., Miles K., Allen A., Quyen NN., Hung NQ., Anh DQ., Tuyen LN., Khoa DB., Thai CQ., Triet DM., Phu NH., Dunstan S., Peto T., Clegg J., Farrar J., Weatherall D.
In order to obtain an approximate assessment of the public health burden that will be posed by the inherited disorders of haemoglobin in southern Vietnam, several thousand individuals were screened for these conditions. A smaller sample was screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The important haemoglobin disorders identified were beta thalassaemia, haemoglobin E and a variety of different forms of alpha thalassaemia. There were sufficient G6PD-deficient individuals to materially affect malaria control programme design. The most remarkable finding was wide variation in the gene frequencies of these conditions among the ethnic groups sampled. The approximate number of babies expected to be born with clinically significant haemoglobin disorders in Vietnam was estimated from the gene-frequency data. This study emphasizes the importance of wide-scale population screening, including ethnic subgroups, to establish the requirements for inherited haemoglobin disorder programmes in resource-limited settings.