Transcript ภาพนิ่ง 1
The Distribution of the Three Target Thalassemia genes through GIS Visualization for Thalassemia Management Case study: Nakhon Chai Bu Rin area, Northeast of Thailand Yupin Jopang*, Rawiwan Puangpruk*, Paripat Netnee*, Vanida Kamonsin* * Regional Health Promotion Center 5, Nakhon Ratchasima BACKGROUND: Thailand has launched a national program for the prevention and control of thalassemia more than a decade but it cannot yet fully achieve its objectives. The main reason is that the general population still lacks of knowledge and awareness about the disease. OBJECTIVE: To apply Geographic Information System (GIS) to create information of the epidemiology of thalassemia for contributing to the deeper understanding of general public and also health personnel in Nakhon Chai Bu Rin area (Nakhon Ratchasima, Chaiyaphom, Buriram and Surin provinces), in the Northeast of Thailand. METHODS: Blood samples with positive results by the screening tests during a prevention and control program were referred from 45 community hospitals in Nakhon Chai Bu Rin area for confirmation of hemoglobin typing to the Regional Health Promotion Center 5, Nakhon Ratchasima during 2012, September to 2014, January. There were 22 , 8, 8, and 7 hospitals from Nakhon Ratchasima, Chaiyaphom, Buriram, and Surin province, respectively. The distribution of three forms of thalassemia genes including a–thalassemia 1 , b-thalassemia and HbE gene per each province were plotted by using Quantum GIS software. RESULTS: A total of 10,170 carriers, 6,896 (67.8%) were found to carry thalassemia gene causing severe thalassemia diseases. An interaction of more than one thalassemia genes was also found. Nakhon Ratchasima, Chaiyaphom, Burirum and Surin province were found 3,313, 875, 1,354, and 1,356 carriers, respectively. Two hundred and thirty three a-thalassemia 1, 58 b-thalassemia and 3,026 HbE carriers were found in Nakhon Ratchasima province. Chaiyaphom province was found 68, 15, and 783 athalassemia 1, b-thalassemia, and HbE carriers, respectively. Burirum province was found 79, 15, and 1,253 a-thalassemia 1, bthalassemia, and HbE carriers, respectively and the last one, Surin province, found 46, 10, and 1,280 a-thalassemia 1, bthalassemia, and HbE carriers, respectively. All of those in each province were plotted the distribution of gene by using Quantum GIS software. This study showed that GIS visualization was an effective instrument for mapping data that could lead to better understanding of thalassemia distribution. It that clearly illustrates HbE was the most prevalent abnormal hemoglobin in this area. a-thalassemia 1 gene b-thalassemia gene HbE gene CONCLUSIONS: Nakhon Chai Bu Rin area, northeast of Thailand is highly frequent of thalassemia, especially HbE. Using a distribution of the three target thalassemia genes through GIS visualization makes it easier for health personnel to determine location of high prevalence of thalassemia and population at risk. Moreover, it also could be applied to management of prevention and control thalassemia into three levels. First, an individual level, the health personnel who response the risk area can provide knowledge for individual or their family. It is helpful the target group to know their problems and felt awareness about family planning. Second, primary health care unit or community hospital level, the health personnel know the epidemiology of thalassemia gene in their area and can identify location of high prevalence for solving the problem. The last, a regional health promotion center level, can be used to provide information to make recommendations on national policy. LIMITATION : Data was carried out in only 45 community hospitals from those of 87 hospitals (51.7%) of Nakhon Chai Bu Rin area. The area did not represent all community hospitals and data from records kept regularly by the local health personnel was not transferred to the system directly. A point feature was made by manual. The software of Quantum GIS is needed to develop the ability to retrieve data from routine for supporting health personnel to manage thalassemia workforce. ACKNOWLEDGEMENT : We thank Dr. Sinsakchon Aunprom-me for helpful writing editing.