Prevention strategies for severe hemoglobinopathies in endemic and nonendemic immigration countries: the Latium example

Objective To review prevention data for hemoglobinopathies from Latium, a large Italian region with a considerable immigrant population and with a well-established regional prevention program. Method All data pertaining to Population screening for hemoglobinopathies ill the Latium region were reviewed for the period 1994-2007. Screening was performed universally in secondary schools and to pregnant Couples at the time of prenatal care. We have examined the trends in positive screening results its well as the type of hemoglobinopathies detected during file study period, and we have correlated them to the type of population (immigrant vs indigenous). Results From 1994 to 2007, 167235 individuals were examined for carrier Status for hemoglobinopathies, and 10 353 of them (6.2%) were immigrants. We have registered a threefold increase in rates of screen-positive subjects who belonged to ethnic minorities during the study period (front 2.7% in 1994 to 9.8% in 2007). Over half of the screen-positive subjects (5397/10353) presented no hematological anomalies, 24% (n = 2472) had iron deficiency, and 24% (n = 2484) was classified as putative carriers. Among the last group, 22.6% were carriers of beta-thalassemia, 49% were suspected alpha-thalassemia carriers, and the remainder had less common hemoglobinopathies. While the prevention program resulted in nearly zero births of autochthonous newborns affected by severe hemoglobinopathies, a rise in number of affected individuals was noted among immigrants. Screening of secondary school students was accepted by 67% of immigrant parents, resulting in 9737 pupils screened between 2002 and 2006. Conclusion Existing preventive programs severe hemgolobinopathies should adapt to changes in population ethnicities. Screening for hemoglobinopathies at school age is ail efficient strategy. Copyright (C) 2009 John Wiley & Sons, Ltd.