Prevalence of hemoglobinopathies in the Brazilian adult population: National Health Survey 2014-2015

Rosenfeld, Luiz Gastão; Bacal, Nydia Strachman; Cuder, Maria Alice Martins; Silva, Alanna Gomes da; Machado, Ísis Eloah; Pereira, Cimar Azereido; Souza, Maria de Fátima Marinho de; Malta, Deborah Carvalho

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 22 (Suppl 02) • 2019 • https://doi.org/10.1590/1980-549720190007.supl.2 copy

Prevalence of hemoglobinopathies in the Brazilian adult population: National Health Survey 2014-2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objective:

To describe the prevalence of hemoglobinopathies in the Brazilian adult population, according to laboratory tests from the National Health Survey.

Methods:

A descriptive study was carried out with National Health Survey laboratory data collected between 2014 and 2015. The hemoglobinopathies test was performed using the High Performance Liquid Chromatography method. The results of the individual tests were interpreted as providing normal, homozygous or heterozygous results for S, C and D hemoglobin, in addition to other possible hemoglobinopathies. Prevalence of hemoglobinopathies according to gender, skin color, region, age and schooling was estimated.

Results:

Hemoglobinopathies were present in 3.7% of the population. The main ones were the sickle cell trait (2.49%), thalassemia minor (0.30%) and suspected thalassemia major (0.80%). In relation to the sickle cell trait and suspected thalassemia major, there was a statistically significant difference for the skin color variable (p<0.05). The prevalences found for sickle cell trait according to skin color was: 4.1% among dark-skinned blacks, 3.6% among light-skinned blacks, 1.2% among whites, and 1.7% among others.

Conclusion:

The most prevalent hemoglobinopathies were the sickle cell trait and minor thalassemia, and were predominate among light- and dark-skinned black people. The study helps in identifying hemoglobinopathies and in genetic counseling in pre-conception.

Keywords:
Sickle cell anemia; Sickle cell trait; beta-Thalassemia; Hemoglobin C; Fetal hemoglobin; Neonatal screening

	N	%	95%CI
Normal	8,388	96.34	95.77 - 96.83
Sickle cell trait	234	2.49	2.10 - 2.97
Minor thalassemia and suspected major talassemia	87	1.10	0.84 - 1.43
HbC carrier	2	0.04	0.01 - 0.21
Probable carrier of persistant HbF	3	0.03	0.01 - 0.12
Association of sickle cell trait with HbC	1	0.003	0.00 - 0.02
Total	8,715	100

Variables (n = 327)	Sickle cell trait			Minor thalassemia			Suspected major thalassemia			Minor thalassemia + Suspected major thalassemia
Variables (n = 327)	%	95%CI	P	%	95%CI	P	%	95%CI	P	%	95%CI	P
Gender
Male	2.6	2.0 - 3.4	0.653	0.3	0.1 - 0.7	0.778	0.6	0.3 - 1.0	0.20	0.9	0.6 - 1.4	0.227
Female	2.4	1.9 - 3.0	0.653	0.4	0.2 - 0.8	0.778	0.9	0.6 - 1.3	0.20	1.3	0.9 - 1.8	0.227
Age group
18 to 29	2.5	1.7 - 3.7	0.889	0.4	0.1 - 1.1	0.730	0.9	0.5 - 1.7	0.59	1.2	0.7 - 2.2	0.552
30 to 44	2.3	1.6 - 3.1		0.3	0.1 - 0.9		0.9	0.5 - 1.5		1.2	0.8 - 1.9
45 to 59	2.7	2.0 - 3.6		0.5	0.2 - 1.1		0.7	0.3 - 1.2		1.1	0.7 - 1.9
60 or older	2.6	1.8 - 3.7		0.2	0.0 - 0.8		0.5	0.3 - 0.9		0.7	0.4 - 1.2
Education level
No education and did not complete elementary school	3.0	2.4 - 3.8	0.166	0.4	0.2 - 0.9	0.664	0.8	0.5 - 1.3	0.22	1.3	0.9 - 1.8	0.234
Completed elementary school and did not complete high school	2.5	1.5 - 4.0		0.3	0.1 - 1.0		1.2	0.6 - 2.4		1.5	0.8 - 2.8
High school or higher completed	2.1	1.5 - 2.8		0.3	0.1 - 0.7		0.6	0.3 - 1.0		0.8	0.5 - 1.3
Skin color
White	1.2	0.8 - 1.9	< 0.001	0.4	0.2 - 1.0	0.554	0.3	0.1 - 0.6	< 0.001	0.7	0.4 - 1.3	0.087
Dark-skinned black	4.1	2.7 - 6.0		0.4	0.1 - 1.7		1.4	0.7 - 2.8		1.8	1.0 - 3.3
Light-skinned black	3.6	2.9 - 4.5		0.2	0.1 - 0.4		1.1	0.8 - 1.7		1.4	1.0 - 1.9
Other	1.7	0.5 - 5.6		0.0			0.0			0.0

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[1] Corresponding author: Deborah Carvalho Malta. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte, MG, Brazil. Email: dcmalta@uol.com.br