Thalassaemia in Britain: a tale of two communities

General practice p 788 The thalassaemias are recessively inherited haemoglobin disorders with profound implications for individuals, families, and health services.1 In the United Kingdom they occur mainly in certain minority ethnic communities, but prevalence varies within these communities. Around 3-10% of Indians, 4.5% of Pakistanis, 8% of Bangladeshis, 17% of Cypriots, 0.5-1% of Afro-Caribbeans, and 0.1% of the indigenous British carry thalassaemia.2 Carrier couples have a one in four chance in every pregnancy of having a child with a major thalassaemia. Unlike some other genetic disorders, the thalassaemias are common and manageable, requiring, as a minimum, regular blood transfusions and iron chelation treatment to prevent iron overload. The cost of supporting a patient from birth to 30 years is estimated at about £250 000.3 Haemoglobin disorders can be prevented by carrier screening and genetic counselling, with the option of …