تا چه اندازه در برنامه کشوری پیشگیری از تالاسمی ماژور در دانشگاه علوم پزشکی مازندران (1381-1371) موفق بوده ایم؟

Background and purpose : Beta thalassemia is the most common genetic disease in the world. Ït has a high prevalence in Ïran and in Mazandaran province in particular. Hence, it is of the first priority of preventing programs of non-communicable diseases. The main preventing measures are proziding appropriate information for public nad professionals, Screening and conceating of at risk families as with as screening of the general diagnosis taboratories was the most recent step of the program. The present study was under taken in order to assess the impact of premanieteel screening and all other activities in controlling thalasemia major 10 years after they first implemented. Materials and methods: Medical and administrative reconds of thalasemia clinic of Boo Âli Sina hospital and deputy of health of Mazandaran university of Medical Sciences were reviewed. Ânnual new and expired patient to as well as the patient’s age at the first negistration were extracted the reason of not using prenatal diagnosis services by carrier parents aware of their situation, was also noted. Fanity planning methods used by 100 at risk families randomly chosen from hoopital records in two separate time periods were also analyzed and reported. The number of screened couples per year. The percentage of cooples who were both minor and avoided marriage after undergiong consealing was extracted, the total number of minor couples under family planning programs, considering the prevention method being used, pregnancy rate, precentage of using prenatal diagnosis services and their results were reported. Based on the birth rate and the chance of being Beta thalassemia in each pregnancy, the number of pregnancies being teminated was capcatated. Çonsidering the annual expenses of the care provided to each patients, the cost benefit rate was calculated. Results: The number of Beta thalassemia patient, regiotered at Boo Âli Sina hospital in 1993 were 500. The mean number at annual new cares was so untill 1996. from 1996 to 2002, nowerer, a mean umber of 35 new mostly old and intermediate cases was recorded. The numer of sreened couples rose from 1500 in 1994 to 24000 in 2003. The number of diagnosed minor couples increazed from 24 in 1997 to 330 in 2002 accordingly. The mean percontage of marriages avoided was 51% in all years. Ât present, 1926 minor coaples (with or without thalasemic child) are under family planning programs among which, 64% use safe method of family planning and 14% do not have fertility condition, 60 pregnancies were necroded in this period of which 83.6% gained benefit from prenatal diagnosis. Çonsidering the chance of thalassemic child being borne (25%) at least 234 thalassemic birtho were averted. Based of the calculations of the miniotry of health, the cost of health care for each beta thalassemia care is $6500 annually therefore the amount saved is easily calculated. Çonclusion: Ône decade after implemeting the thalassemia preventing measures in Mazandaran provice, suceess is made reducing the number of new thalassemia cases.