High Prevalence of Anemia and Inherited Hemoglobin Disorders in Tribal Populations of Madhya Pradesh State, India

Despite estimated high prevalence of inherited hemoglobin (Hb) disorders among tribal populations in Madhya Pradesh State, India, the burden of disease is unknown, leading to high morbidity and associated mortality. Our aim was to screen tribal populations in designated tribal districts of Madhya Pradesh State for various hemoglobinopathies and to estimate the prevalence and plausible cause of anemia. The present study screened a total of 3992 tribal individuals comprised of students of Tribal schools, ashrams of Dindori, Mandla, and Chhindwara districts of Madhya Pradesh State. Screening of hemoglobinopathies was done using Hb electrophoresis and or high performance liquid chromatography (HPLC), alpha-thalassemia (alpha-thal) was detected using polymerase chain reaction (PCR). The median age of the studied cohort was 15 years (interquartile range 13-16 years). High prevalence (76.7%) of anemia was observed among the studied cohort. The prevalence of sickle cell trait and sickle cell disease varies from 10.7 to 15.6% and 0.4 to 0.8%, respectively. The allele frequency of sickle cell gene was highest in the Pradhan tribe followed by the Panika tribe. Dindori district had the highest prevalence of sickle cell trait. beta-Thalassemia (beta-thal) trait was observed in only 1.4% of the screened population. alpha Gene deletions were observed in 84.7% individuals. Significant association of alpha gene deletion mutations with mean Hb, mean corpuscular volume (MCV), and mean corpuscular Hb (MCH) was observed. The Bharia tribe showed the highest prevalence for alpha-thal. For comprehensive health care, effective intervention programs are needed to reduce the high prevalence of anemia and hemoglobinopathies among tribes.