The incidence of nontransfusion-transmitted infectious diseases in β thalassemia major patients at Cipto Mangunkusumo Hospital

Abstract

Background The statement that thalassemic children are more prone to infection than normal children has been accepted as a part of thalassemia literatures for years. Recently this concept has been questioned, and certainly it has impressed the clinicians that the incidence of infection in thalassemia in early childhood is re- duced by adequate blood transfusion although this has not been documented. However, iron overload favors bacteria to acquire iron necessary for their growth. Excess iron deposit may damage immune response in thalassemic patients. Objective The aim of this study was to find out whether there was any increasing episode of nontransfusion-transmitted infectious dis- eases in thalassemic patients. Design Observational, cross sectional study. Setting Thalassemia outpatient clinic at the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Patient Two hundreds subjects by consecutive sampling, grouped by their total volume of transfusion into ≥5 liters or <5 liters groups. Results The numbers of patients receiving transfusion ≥5 liters who had 1,2,3,4 and 5 times episodes of influenza in 6-month pe- riod were 69, 20, 3, 2, and 2 out of 173 patients respectively and in patients receiving transfusion less than 5 liters,14/27 had influ- enza for 1-2 times in 6-month period. The incidence of diarrhea in patients receiving transfusion ≥5 liters was 11.5%, once to twice in 6 months and in patients receiving transfusion less than 5 liters, 7/ 27, 1-2 times in 6 months. There was no difference in the inci- dence of influenza and diarrhea between the two groups. Conclusion It seemed that there was no any increasing incidence of nontransfusion-transmitted infectious diseases in thalassemic patients in accordance with total volume of blood transfusions

Keywords

• thalassemia
• immune response
• incidence of infection