Monday August 08, 2022

Incidence of aplastic anemia very high in Pakistan, say experts

July 04, 2022

The incidence of aplastic anemia is very high in Pakistan as compared to Western countries as hundreds of new cases are being reported in the country every year, health experts said on Sunday, adding the in addition to genetic causes, environmental factors, including exposure to pesticides, herbicides and use of certain medications, such as chloramphenicol, mebendazole and radiation, could be the possible causes of the blood disease.

Aplastic anemia is a rare blood disorder in which bone marrow of a person stops producing blood cells, health experts explained and called for initiating studies on national level to find out causes behind high incidence of the disease in Pakistan so that preventive measures could be adopted. Most of the people cannot afford the treatment, i.e. bone marrow transplant (BMT), which is expensive and unaffordable for most of the patients.

They were speaking at the 3rd National Symposium on Paediatric Haematology and Oncology at the Children’s Hospital Karachi. It was addressed by paediatric hematologists and oncologists as well as pharmacists and other health specialists from different cities of Pakistan.

Renowned pediatric hematologist Dr Saqib Husain Ansari said the incidence of aplastic anemia is unusually high in Pakistan as well as neighbouring countries, including India and Bangladesh, as compared to that in Western countries. They said environmental factors, especially excessive use of pesticides, herbicides, exposure to petroleum products, radiation and self-medication, were to blame for this situation.

“If one person is diagnosed with aplastic anemia in six months at a healthcare facility in any Western country, we see over 125 to 150 such patients in the same period at our health facilities. In addition to genetic causes, there are some environmental factors behind this disease, which need to be probed as its treatment is bone marrow transplant, which is very expensive and not everybody can afford it,” he added.

Speaking about thalassaemia, Dr Ansari said that despite the promulgation of a law for the prevention of thalassaemia in the Sindh province, marriages were still taking place without the testing of both the bride and the groom for the genetic disease. He opined that by implementing on the law, births of hundreds of children with hereditary blood disease could be prevented.

Eminent pharmacist Umaima Muzammil said that the use of some medicines which are banned in the developed world including antibiotic drug chloramphenicol is also associated with high incidence of Aplastic Anemia. She urged the Drug Regulatory Authority of Pakistan o halt the production and availability of hazardous medicines.

“We are also manufacturing several herbal medicines for which we have no safety data. Some of the allopathic drugs are known for causing Aplastic anemia while herbal, Unani and Hakeemi medicines also contain compounds which could suppress bone marrow and cause such blood disorders.”

Renowned paediatrician Prof Jalal Akbar said that every year hundreds of children are born with thalassaemia in Pakistan, which is a preventable disease, and called for implementation of laws as well as creating awareness among the people so that the birth of thalassaemic children could be prevented.

The head of clinical haematology and bone marrow transplantation at the Dow University of Health Sciences (DUHS), Prof Dr Farrukh Ali Khan said the Western world and several other countries managed to eradicate thalassaemia from their soils and now they were using those resources for the treatment of blood cancers. He called for focusing on the prevention of thalassaemia and other preventable diseases.

Speaking about Aplastic Anemia, Dr Farrukh said the prevalence of this disease was very high in Pakistan, but unfortunately experts in the country had failed to identify the factors behind its high prevalence. He added that maybe there was something wrong with the diet of people in the region, but there was a need for extensive research on this disease to control it.

“As far as thalassaemia is concerned, we clearly know that if two thalassaemia minor people marry each other, there is a 25 per cent chance that they child would be thalassaemia major,” he said and called for steps to prevent this disease in the country.

Dr Zubair Shaikh, president of Muhammad Ali Jinnah University, Karachi, Dr Uzma Zaidi from the NIBD, Dr Tariq Ghafoor from the Armed Forces Bone Marrow Transplant Centre Rawalpindi, Dr Mohsina Ibrahimk from the National Institute of Child Health, Karachi, Dr Akbar Nizamani from the LUMHS Jamshoro and several other experts also spoke.