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|Title:||The Changing Epidemiology of Pediatric Hemoglobinopathy Patients in Northern Alberta, Canada|
|Authors:||Catherine Corriveau-Bourque;Aisha A. K. Bruce|
|subject:||sickle cell disease, thalassemia, hemoglobinopathy, migration, population growth|
|Abstract:||Hemoglobinopathies such as sickle cell disease and thalassemia are disorders of hemoglobin (Hb) production, which impact millions of people worldwide and affect populations originating from areas where malaria is endemic. They represent a growing public health burden, with significant morbidity and mortality. It is estimated that each year approximately 300,000 infants are born worldwide with a major hemoglobinopathy.1 Because of advances in the field, including the early identification of cases through newborn screening,2–4 as well as therapeutic and preventative advances such as pneumococcal immunizations and penicillin prophylaxis,5–7 the rate of mortality has decreased substantially in the developed world. These advances have been so successful that in areas where these practices are implemented, sickle cell–related childhood mortality has decreased dramatically.8 Nevertheless, even with advanced screening and therapies, people with hemoglobinopathies continue to have complex medical needs requiring hospitalizations and multidisciplinary care. In addition, ongoing clinical monitoring is required for the prevention and management of disease-associated complications. In the United States, the prevalence of sickle cell disease is approaching 100,000 people9 and 1000 people with severe thalassemia.10 However, in Canada, accurate epidemiologic data in the hemoglobinopathy patient population are lacking at a national and provincial level. While the overall population and demographics in Canada are different than the United States, during the last 60 years, Canada’s population has increased by >20 million. Currently, two thirds of Canada’s population growth can be attributed to international migration.11 In the past 10 years, 2 million people have immigrated to Canada, and about 1 in 5 Canadians was born abroad.11 Immigrants report nearly 200 different countries as their place of birth, demonstrating the diversity within Canada. In the past the majority of migrants were of European origin; however, due to a change in immigration regulations in 1967, there has been a progressive shift in country of origin such that now 57% originate from Asia, 12.5% from Africa, and 12.3% from Latin America.12|
|Appears in Collections:||Journal of pediatric hematology oncology 2015|
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