Evolution of hemoglobinopathy prevention in Africa: results, problems and prospect

Hemoglobinopathies are a group of inherited hemoglobin disorders. Initially described in the subtropical regions, they are now spread all around the world because of migration. Their high frequency and clinical severity make them a major public health problem mostly in Africa due to the limited resources reserved for the management and prevention of these diseases. Despite considerable advances in the control and management of the hemoglobinopathies, therapeutic approach and follow- up still pose problems because of the major economic and organizational difficulties in the developing countries, particularly in Africa where problems are majored by other factors including social and cultural backgrounds, high consanguinity, as well as the coexistence of infection and malnutrition. Effective prevention programs have been carried out successfully in many European countries concerned by hemoglobinopathies. They should be extended to African regions where hemoglobin disorders account for more than 70% of total hemoglobinopathies in the world. Prevention should remain the major priority of health services to reduce incidence of hemoglobinopathies in Africa. Hereby we present the Tunisian experience that may reflect globally the profile of the prevention evolution of hemoglobinopathies in North Africa.