Infection, Psychological Distress, and Financial Burden Among Transfusion-Dependent Β-Thalassemia Patients in South Punjab, Pakistan: A Cross-Sectional Study

Background: TDT is a lifelong condition of blood transfusion and chelation therapy of Iron. However, patients still experience recurrent infections, psychological problems and financial difficulties. Generally, these dimensions are studied in isolation with limited integrated evidence from the context of Pakistan. Objective: To compare various clinical, psychological and financial problems in patients with TDT in a tertiary care hospital in Dera Ghazi Khan, South Punjab, Pakistan. Methods: A descriptive cross-sectional study was done in the Thalassemia Care Unit, Allama Iqbal Teaching Hospital for a period of four months. The participants were 120 children aged 5-30 years with β-thalassemia major who were on regular transfusion for at least 1 year were recruited purposively. Data were gathered by a structured questionnaire, clinical checklist, and observation sheet and analyzed in SPSS version 26. Descriptive statistics, Chi-square test, Independent t-test and ANOVA was performed and the p-value of ≤ 0.05 was considered statistically significant. Results: 62% (n = 120) had at least 1 infection within the last year. Splenectomized patients were significantly more likely to become infected (p < 0.01). 68% of patients experienced moderate to severe anxiety and 72% of families reported a considerable financial cost associated with treatment. Discussion: There are interrelated clinical, psychological, and financial issues that arise in patients with TDT. To achieve better outcomes, a combination of infection prevention, mental health help and financial support, within an integrated, holistic and patient-centered approach to nursing care, is required with the support of health policy.