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A Review on Situation of Congenital Disorders and Access to Community Genetics Services in Bangladesh

Ashim Roy and Lela Shengelia

About 2-3% of all live births suffer from congenital abnormality globally and 70% of those are preventable through community genetics services. There is no population-wide data on congenital disorders in Bangladesh. The objectives of this article are: to identify the prevalence of the common congenital disorders, to assess the factors influencing congenital disorders and to assess the situation of access to the community genetics services in Bangladesh. A review has been conducted with formal and informal searches. The estimated prevalence of congenital abnormalities is about 2-4% in live births along with still born and aborted fetus. Neural tube defects are the commonest congenital abnormality. Other common defects involve gastrointestinal, cardiovascular, genitourinary and musculoskeletal system. Down’s syndrome shares majority, nearly 71%, of all chromosomal abnormality. The ethnic variations in the prevalence of Beta thalassemia trait and HbE trait are respectively 4.1% and 6.1% in Bengali students of nine and ten grade and that in the tribal students of same grade 4.2% and 41.7%. The electrophoretic patterns and distributions of hereditary hemoglobin disorders in cases are: thalassemia trait-47.14%, HbE-beta thalassemia-30.47%, HbE trait-13.3%, HbE disease-5.71% and thalassemia major-3.33%. The prevalence of haemophilia-A is 0.4/100,000 males that of congenital hypothyroidism is 1/(1300-1353) newborns. Key factors associated with the burden of congenital disorders in Bangladesh are: high prevalence of carriers of genetic diseases along with consanguineous marriage, inadequate antenatal check-up, high rate (nearly 72%) of unskilled home delivery and lack of community genetics services. Political and professional prioritization of community genetics services through the existing primary health care resources is a priority social, health and economic interest for effectively addressing the problem of congenital disorders in Bangladesh.