[Thalassemia Reports 2011; 1(s2):e4] [page 9]
Thalassemia Reports 2011; volume 1(s2):e4
Abstract
Thalassemia and abnormal haemoglobins are a serious health prob-
lem in Turkey. Very important steps for toward preventing thalassemia
have been taken in Turkey by Ministry of Health (MOH), Turkish
National Haemoglobinopathy Council (TNHC) and Thalassemia
Federation of Turkey (TFT) since 2000. In 1993, a law was issued called
Fight Against Hereditary Blood Disease especially for thalassemia and
haemoglobinopathies. The law commends to prevent haemoglo-
binopathies and to treat all patients with haemoglobinopathy and tha-
lassemia. A pilot project was started and centres were created in the
MOH Hospitals in the southern provinces of Turkey. In 2000, TNHC
was installed to combine all centres, foundations, and associations
into one organization controlled by the MOH. In 2001, the MOH and
the TNHC made an inventory of all recorded patients with thalassemia
and abnormal hemoglobins in Turkey, registering at least 4513
patients. In 2002, written regulations for the Fight Against Hereditary
Blood Disease were published. MOH and TNHC selected 33 provinces
situated in the Thrace, Marmara, Aegean, Mediterranean and South
Eastern regions with high birth prevalence of severe haemoglo-
binopathies. In 2003, the haemoglobinopathy scientific committee was
set-up, a guidebook was published and a national Hemoglobinopaty
Prevention Program (HPP) was started in these high risk provinces .
This program is running in these provinces successfully. In 2005, TFT
was established as a secular society organization instead of TNHC. In
2007, National Thalassemia Prevention Campaign (NTPC) was organ-
ized for public education by TFT. This campaign contributed very
important supporting to HPP in Turkey, because totally 62.682 people
such as health workers, students, teachers, demarches, religion offi-
cers and the other many people were educated for preventing tha-
lassemia and haemoglobinopathies. In 2009, National Thalassemia
Education Seminars (NTES) for health personnel have been planned
in 26 cities by MOH and TFT. A total 3.600 health persons were educat-
ed on thalassemia prevention and therapy with NTES in 18 centres in
2009 and 2010. In conclusion, according to reports of MOH, 46 first
level haemoglobinopathy diagnosis centres, 5 second level diagnosis
and therapy centre and 5 third level prenatal diagnosis centre were set-
up and licenced in 30 cities between 2003 and 2009. While premarital
screening tests were 30% of all couples in 2003, it increased continu-
ously during 6 years and it reached 81% in 2008. The number of new
born with thalassemias and hemoglobinopathies was 272 in 2002, it
was decreased to 23 in 2008, as a result there has been an 90% reduc-
tion in new affected births.
Background
In 1958, the first clinical and hematological studies on thalassemia
and haemoglobinopathies in Turkey was published by Aksoy et al [1].
In 1971, Çavdar and Arcasoy reported that overall incidence of β-tha-
lassemia in Turkey was 2.1%.
2
In 1983, first prenatal diagnostic proce-
dures for identifying haemoglobinopathies were performed by Altay et
al.
3
In 1987, Akar et al. showed that the most frequent thalassaemia
allele in the Turkish population was the IVS-1 nt 110 mutation, which
was the most common thalassaemia mutation in the majority of the
high risk regions of the Mediterranean area.
4
In 1992, Başak et al.
reported the spectrum of β-thalassemia mutations occuring in the
Turkish population.
5
In 1993, a law was issued called Fight Against
Hereditary Blood Disease a pilot Project was started and centres for
Research and Treatment for Hereditary Blood Disease were created in
the Ministry of Health (MOH) Hospitals in the south provinces of
Turkey, Antalya, Antakya, Mersin, Mugla regions. In 2000, Turkish
National Hemoglobinopathy Council (TNHC) was installed to combine
all centres, foundations and associations into one organization con-
trolled by the MOH. In 2001, the MOH and the TNHC made an invento-
ry of all recorded patients with thalassemia and abnormal haemoglo-
bins in Turkey.
6-8
In 2002, Altay published that screening studies for
abnormal haemoglobins and β-thalassemia during the last 40 years.
These studies revealed most common abnormal haemoglobin was HbS
followed by Hb D, HbE, and Hb O Arab. In addition 42 abnormal haemo-
globins were identified in Turkish population.
9
In 2002, written regu-
lations for the Fight Against Hereditary Blood Disease (FAHBD) were
published. MOH and TNHC selected 33 provinces situated in the
Thrace, Marmara, Aegean, Mediterranean and South Eastern regions
with high birth prevalence of severe haemoglobinopathies.
Haemoglobinopaty Prevention Program (HPP) was started in these
high risk provinces on the 8th of May, 2003.
6-8
The aims of HPP are following up: i) to assess the present situation
in each region by recording patients and carrier, ii) to produce a
Correspondence: D. Canatan, MD, President of Thalassemia Federation of
Turkey, President of Akdeniz Kan Hastaliklari Vakfi, Antalya, Turkey.
Tel./Fax: +90.242. 2432020-21. E-mail: dcanatan@superonline.com
www.talasemifederasyonu.org.tr - www.akhav.org.tr
Key words: haemoglobinopathy prevention program, Turkey.
©Copyright D. Canatan, 2011
Licensee PAGEPress, Italy
Thalassemia Reports 2011; 1(s2):e4
doi:10.4081/thal.2011.s2.e4
This article is distributed under the terms of the Creative Commons
Attribution Noncommercial License (by-nc 3.0) which permits any noncom-
mercial use, distribution, and reproduction in any medium, provided the orig-
inal author(s) and source are credited.
Parts of this work were presented at the “12th International Conference on
Thalassemia and Hemoglobinopathies”, Antalya (Turkey), 11-14 May 2011.
Haemoglobinopathy prevention program in Turkey
D. Canatan
President of Thalassemia Federation of Turkey, President of Akdeniz Kan Hastaliklari Vakfi
Antalya, Turkey
Non-commercial use only