Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Health-related quality of life in pediatric and adolescent patients with transfusion-dependent ß-thalassemia in upper Egypt (single center study)

Authors: Gehan L Abdel Hakeem, Suzan O Mousa, Asmaa N Moustafa, Mohamed H Mahgoob, Ebtesam E Hassan

Published in: Health and Quality of Life Outcomes | Issue 1/2018

Login to get access

Abstract

Background

Thalassemia is a major health problem that disturbs the lifestyle of the affected patient. The aim of this work is to detect the impact of thalassemia on the quality of life regarding physical, social, emotional, psychological scored assessment.

Methods

A case-control survey was conducted in Minia University children’s hospital on 64 patients recruiting pediatric hematology outpatient clinic from July 2014 to February 2017. PedsQL™ 4.0 Generic Core Scale (Arabic version) was used to assess HRQOL in 64 thalassemia patients between 8 and 18 years of ages. Other related clinical data of the involved patients were collected from the pediatric hematology records.

Results

Mean physical, emotional, social, school performance, psychological and total scores (− 36.9 ± 20.9, 49.4 ± 17, 47.2 ± 21.3, 38.5 ± 15.5, 45.3 ± 13.8, 47.9 ± 38.8 respectively) were significantly decreased compared with control (p = 0.001 for all). The younger age group had better scores regarding social, emotional, psychological and total scores compared to older ones (p = 0.01, 0.03, 0.01 and 0.009 respectively). Older age of starting transfusion was statistically significant protecting factor from poor physical QOL in thalassemia patients (OR = 0.96, p = 0.03). The presence of hepatomegaly was a statistically significant predictor for poor physical QOL (OR = 8.5, p = 0.02). Household income was the statistically significant predictor for poor emotional QOL (OR = 5.03, p = 0.04). High serum ferritin was the statistically significant predictor for poor social QOL (OR = 1.1, CI 95%=, p = 0.04). Regarding poor psychological QOL (OR = 0.94, p = 0.01) and total QOL (OR = 0.94, p = 0.01) scores, older age of starting transfusion was the statistically significant protecting factor.

Conclusion

Scheduled programs giving psychosocial help and a network connecting between the patients, school officials, thalassemia caregivers and the physician is required especially in developing countries where the health services are not integrated with social organizations. Special school services for thalassemia patients are required to deal with the repeated absence and anemia induced low mental performance of thalassemia children.
Literature
1.
go back to reference Weatherall DJ, Clegg JB. The thalassemia syndromes. 4th ed. Oxford, England: Blackwell Science Ltd, 2001. Weatherall DJ, Clegg JB. The thalassemia syndromes. 4th ed. Oxford, England: Blackwell Science Ltd, 2001.
2.
go back to reference Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353:1135–46. Article|PubMed|ISI|ChemPortCrossRefPubMed Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med. 2005;353:1135–46. Article|PubMed|ISI|ChemPortCrossRefPubMed
4.
go back to reference Olivieri N, Weatherall DJ. Clinical aspects of β-thalassemia. In: Steinberg MH, Forget BG, Higgs DR, Nagel RL, editors. Disorders of hemoglobin, genetics, pathophysiology, and clinical management. Cambridge, England: Cambridge University, 2001;277–341. Olivieri N, Weatherall DJ. Clinical aspects of β-thalassemia. In: Steinberg MH, Forget BG, Higgs DR, Nagel RL, editors. Disorders of hemoglobin, genetics, pathophysiology, and clinical management. Cambridge, England: Cambridge University, 2001;277–341.
5.
go back to reference Voskaridou E, Anagnostopoulos A, Konstantopoulos K, et al. Zoledronic acid for the treatment of osteoporosis in patients with beta-thalassemia: results from a single-center, randomized, placebo-controlled trial. Haematologica. 2006;91:1193–202.PubMed Voskaridou E, Anagnostopoulos A, Konstantopoulos K, et al. Zoledronic acid for the treatment of osteoporosis in patients with beta-thalassemia: results from a single-center, randomized, placebo-controlled trial. Haematologica. 2006;91:1193–202.PubMed
6.
go back to reference Voskaridou E, Terpos E. New insights into the pathophysiology and management of osteoporosis in patients with beta thalassemia. Br J Haematol. 2004;127:127–39. Article|PubMed|ChemPortCrossRefPubMed Voskaridou E, Terpos E. New insights into the pathophysiology and management of osteoporosis in patients with beta thalassemia. Br J Haematol. 2004;127:127–39. Article|PubMed|ChemPortCrossRefPubMed
7.
go back to reference Origa R, Fiumana E, Gamberini MR, et al. Osteoporosis in beta-thalassemia: clinical and genetic aspects. Ann N Y Acad Sci. 2005;1054:451–6.CrossRefPubMed Origa R, Fiumana E, Gamberini MR, et al. Osteoporosis in beta-thalassemia: clinical and genetic aspects. Ann N Y Acad Sci. 2005;1054:451–6.CrossRefPubMed
8.
go back to reference El Beshlawy A, Mokhtar G, Abd El Ghafar E, Abd El Dayem S, El-Sayed M, Aly A, Farok M. Assessment of puberty in relation to L-carnitine and hormonal replacement therapy in β-thalassemia patients. Tropical. Pediatrics. 2008;54(6):375–81. El Beshlawy A, Mokhtar G, Abd El Ghafar E, Abd El Dayem S, El-Sayed M, Aly A, Farok M. Assessment of puberty in relation to L-carnitine and hormonal replacement therapy in β-thalassemia patients. Tropical. Pediatrics. 2008;54(6):375–81.
9.
go back to reference Atkin K, Ahmad W. Living a “normal life”: young people coping with thalassemia major or sickle cell disorder. Soc Sci Med. 2001;53:615–26.CrossRefPubMed Atkin K, Ahmad W. Living a “normal life”: young people coping with thalassemia major or sickle cell disorder. Soc Sci Med. 2001;53:615–26.CrossRefPubMed
10.
go back to reference Caocci G, Efficace F, Ciotti F, Roncarolo MG, Vacca A, Piras E, Littera R, Markous RS, Collins GS, Ciceri F, Mandelli F, Marktel S, La Nasa G. Health-related quality of life in middle eastern children with beta-thalassemia. BMC Blood Disord. 2012;12:6.CrossRefPubMedPubMedCentral Caocci G, Efficace F, Ciotti F, Roncarolo MG, Vacca A, Piras E, Littera R, Markous RS, Collins GS, Ciceri F, Mandelli F, Marktel S, La Nasa G. Health-related quality of life in middle eastern children with beta-thalassemia. BMC Blood Disord. 2012;12:6.CrossRefPubMedPubMedCentral
11.
go back to reference Bowling A. Current state of the art in quality of life measurement. In: Carr AJ, Higginson IJ, Robinson P, editors. Quality of life. London: BMJ Books; 2003. Bowling A. Current state of the art in quality of life measurement. In: Carr AJ, Higginson IJ, Robinson P, editors. Quality of life. London: BMJ Books; 2003.
12.
go back to reference Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P. The PedsQLin pediatric cancer: reliability and validity of the pediatric quality of life inventory generic core scales, multidimensional fatigue scale, and cancer module. Cancer. 2002;94(7):2090–106.CrossRefPubMed Varni JW, Burwinkle TM, Katz ER, Meeske K, Dickinson P. The PedsQLin pediatric cancer: reliability and validity of the pediatric quality of life inventory generic core scales, multidimensional fatigue scale, and cancer module. Cancer. 2002;94(7):2090–106.CrossRefPubMed
13.
go back to reference Varni JW, Burwinkle TM, Seid M. The PedsQL 4.0 as a school population measure: feasibility, reliability, and validity. Qual Life Res. 2006;15:203–15.CrossRefPubMed Varni JW, Burwinkle TM, Seid M. The PedsQL 4.0 as a school population measure: feasibility, reliability, and validity. Qual Life Res. 2006;15:203–15.CrossRefPubMed
19.
go back to reference Baghianimoghadam MH, Sharifirad G, Rahaei Z, Baghianimoghadam B, Heshmati H. Health-related quality of life in children with thalassemia assessed on the basis of SF-20 questionnaire in Yazd, Iran: a case–control study. Cent Eur J Public Health. 2011;19:165–9.PubMed Baghianimoghadam MH, Sharifirad G, Rahaei Z, Baghianimoghadam B, Heshmati H. Health-related quality of life in children with thalassemia assessed on the basis of SF-20 questionnaire in Yazd, Iran: a case–control study. Cent Eur J Public Health. 2011;19:165–9.PubMed
20.
go back to reference Ismail A, Campbell MJ, Ibrahim HM, Jones GL. Health-related quality of life in Malaysian children with thalassemia. Health Qual Life Outcomes. 2006;4:39.CrossRefPubMedPubMedCentral Ismail A, Campbell MJ, Ibrahim HM, Jones GL. Health-related quality of life in Malaysian children with thalassemia. Health Qual Life Outcomes. 2006;4:39.CrossRefPubMedPubMedCentral
21.
go back to reference Cheuk DK, Mok AS, Lee AC, Chiang AK, Ha SY, Lau YL, Chan GC. Quality of life in patients with transfusion-dependent thalassemia after hematopoietic SCT. Bone Marrow Transplant. 2008;42:319–27.CrossRefPubMed Cheuk DK, Mok AS, Lee AC, Chiang AK, Ha SY, Lau YL, Chan GC. Quality of life in patients with transfusion-dependent thalassemia after hematopoietic SCT. Bone Marrow Transplant. 2008;42:319–27.CrossRefPubMed
22.
go back to reference Musallam KM, Khoury B, Abi-Habib R, Bazzi L, Succar J, Halawi R, et al. the health-related quality of life in adults with transfusion-independent thalassemia intermedia compared to regularly transfused thalassemia major: new insights. Eur J Haematol. 2011;87:73–9.CrossRefPubMed Musallam KM, Khoury B, Abi-Habib R, Bazzi L, Succar J, Halawi R, et al. the health-related quality of life in adults with transfusion-independent thalassemia intermedia compared to regularly transfused thalassemia major: new insights. Eur J Haematol. 2011;87:73–9.CrossRefPubMed
23.
go back to reference Safizadeh H, Farahmandinia Z, Nejad SS, Pourdamghan N, Araste M. Quality of life in patients with thalassemia major and intermedia in Kerman-Iran (I.R.). Mediterr J Hematol Infect Dis. 2012;4(1):e2012058.CrossRefPubMedPubMedCentral Safizadeh H, Farahmandinia Z, Nejad SS, Pourdamghan N, Araste M. Quality of life in patients with thalassemia major and intermedia in Kerman-Iran (I.R.). Mediterr J Hematol Infect Dis. 2012;4(1):e2012058.CrossRefPubMedPubMedCentral
24.
go back to reference Haghpanah S, Nasirabadi S, Ghaffarpasand F, Karami R, Mahmoodi M, Parand S, Karimi M. Sao Paulo Med J. 2013;131(3):166–72.CrossRefPubMed Haghpanah S, Nasirabadi S, Ghaffarpasand F, Karami R, Mahmoodi M, Parand S, Karimi M. Sao Paulo Med J. 2013;131(3):166–72.CrossRefPubMed
25.
go back to reference Nejad SS, Pourdamghan N, Araste M. Quality of life in patients with thalassemia major and intermedia in Kerman-Iran (I.R.). Mediterr J Hematol Infect Dis. 2012;4(1):e2012058.CrossRefPubMedPubMedCentral Nejad SS, Pourdamghan N, Araste M. Quality of life in patients with thalassemia major and intermedia in Kerman-Iran (I.R.). Mediterr J Hematol Infect Dis. 2012;4(1):e2012058.CrossRefPubMedPubMedCentral
26.
go back to reference Ansari SH, Baghersalimi A, Azarkeivan A, Nojomi M, Hassanzadeh Rad A. Quality of life in patients with thalassemia major. Iran J Ped Hematol Oncol. 2014;4(2):57–63.PubMedPubMedCentral Ansari SH, Baghersalimi A, Azarkeivan A, Nojomi M, Hassanzadeh Rad A. Quality of life in patients with thalassemia major. Iran J Ped Hematol Oncol. 2014;4(2):57–63.PubMedPubMedCentral
27.
go back to reference El Dakhakhny AM, Hesham MA, Mohamed SE, Mohammad FN. Quality of life of school age thalassemic children at Zagazig City. J Am Sci. 2011;7:186–97. El Dakhakhny AM, Hesham MA, Mohamed SE, Mohammad FN. Quality of life of school age thalassemic children at Zagazig City. J Am Sci. 2011;7:186–97.
28.
go back to reference Thavorncharoensap M, Torcharus K, Nuchprayoon I, Riewpaiboon A, Indaratna K, Ubol BO. Factors affecting health-related quality of life in Thai children with thalassemia. BMC Blood Disord. 2010;10:1.PubMedPubMedCentral Thavorncharoensap M, Torcharus K, Nuchprayoon I, Riewpaiboon A, Indaratna K, Ubol BO. Factors affecting health-related quality of life in Thai children with thalassemia. BMC Blood Disord. 2010;10:1.PubMedPubMedCentral
29.
go back to reference Gharaibeh HF, Gharaibeh MK. Factors influencing health-related quality of life of thalassaemic Jordanian children. Child Care Health Dev. 2012;38:211–8.CrossRefPubMed Gharaibeh HF, Gharaibeh MK. Factors influencing health-related quality of life of thalassaemic Jordanian children. Child Care Health Dev. 2012;38:211–8.CrossRefPubMed
30.
go back to reference Saeed N. My life. United Kingdom Thalassemia Society Matters. 2004;99:10. Saeed N. My life. United Kingdom Thalassemia Society Matters. 2004;99:10.
31.
go back to reference Cantaan D, Ratip S, Kaptan S, Cosan R. Psychological burden of beta thalassemia major in Antalya, South Turkey. Soc Sci Med. 2003;56:815–9.CrossRef Cantaan D, Ratip S, Kaptan S, Cosan R. Psychological burden of beta thalassemia major in Antalya, South Turkey. Soc Sci Med. 2003;56:815–9.CrossRef
32.
go back to reference Anionwu E, Atkin K. The politics of sickle cell and Thalassaemia. Buckingham: Open University Press; 2001. Anionwu E, Atkin K. The politics of sickle cell and Thalassaemia. Buckingham: Open University Press; 2001.
33.
go back to reference Naderi M, Hormozi MR, Ashrafi M, Emamdadi A. Evaluation of mental health and related factors among patients with beta thalassemia major in south east of Iran. Iran j psychiatry. 2012;7(1):47–51.PubMedPubMedCentral Naderi M, Hormozi MR, Ashrafi M, Emamdadi A. Evaluation of mental health and related factors among patients with beta thalassemia major in south east of Iran. Iran j psychiatry. 2012;7(1):47–51.PubMedPubMedCentral
34.
go back to reference Yahia S, El-Hadidy MA, El-Gilany AH, Anwar R, Darwish A, Mansour AK. Predictors of anxiety and depression in Egyptian thalassemic patients: a single center study. Int J Hematol. 2013;97(5):604–9.CrossRefPubMed Yahia S, El-Hadidy MA, El-Gilany AH, Anwar R, Darwish A, Mansour AK. Predictors of anxiety and depression in Egyptian thalassemic patients: a single center study. Int J Hematol. 2013;97(5):604–9.CrossRefPubMed
35.
go back to reference Aydinok Y, Eremis S, Bukusoglu N, Yilmaz D, Solak U. Psychosocial implications of Thalassaemia major. Paediatr Int. 2005;47(1):84.CrossRef Aydinok Y, Eremis S, Bukusoglu N, Yilmaz D, Solak U. Psychosocial implications of Thalassaemia major. Paediatr Int. 2005;47(1):84.CrossRef
36.
go back to reference Goldbeck L, Baving A, Kohne E. Psychosocial aspects of beta thalassemia: distress, coping and adherence. Klinik Padiatrik. 2000;212(5):254–9.CrossRef Goldbeck L, Baving A, Kohne E. Psychosocial aspects of beta thalassemia: distress, coping and adherence. Klinik Padiatrik. 2000;212(5):254–9.CrossRef
37.
go back to reference Mikelli A, Tsiantis J. Brief report: depressive symptoms and quality of life in adolescents with b-thalassaemia. J Adolesc. 2004;27:213–6.CrossRefPubMed Mikelli A, Tsiantis J. Brief report: depressive symptoms and quality of life in adolescents with b-thalassaemia. J Adolesc. 2004;27:213–6.CrossRefPubMed
39.
go back to reference McLeod C, Fleeman N, Kirkham J, Bagust A, Boland A, Chu P, et al. Deferasirox for the treatment of iron overload associated with regular blood transfusions (transfusional haemosiderosis) in patients suffering with chronic anemia: a systematic review and economic evaluation. Health Technol Assess (Rockv). 2009;13:iii–v. McLeod C, Fleeman N, Kirkham J, Bagust A, Boland A, Chu P, et al. Deferasirox for the treatment of iron overload associated with regular blood transfusions (transfusional haemosiderosis) in patients suffering with chronic anemia: a systematic review and economic evaluation. Health Technol Assess (Rockv). 2009;13:iii–v.
40.
go back to reference Elalfy MS, Massoud W, Elsherif NH, Labib JH, Elalfy OM, Elaasar S, et al. A new tool for the assessment of satisfaction with iron chelation therapy (ICT-sat) for patients with b-thalassemia major. Pediatr Blood Cancer. 2012;58:910–5.CrossRefPubMed Elalfy MS, Massoud W, Elsherif NH, Labib JH, Elalfy OM, Elaasar S, et al. A new tool for the assessment of satisfaction with iron chelation therapy (ICT-sat) for patients with b-thalassemia major. Pediatr Blood Cancer. 2012;58:910–5.CrossRefPubMed
41.
go back to reference Ho PJ, Tay L, Lindeman R, Catley L, Bowden DK. Australian guidelines for the assessment of iron overload and iron chelation in transfusion-dependent thalassemia major, sickle cell disease, and other congenital anemias. Intern Med J. 2011;41:516–24.CrossRefPubMed Ho PJ, Tay L, Lindeman R, Catley L, Bowden DK. Australian guidelines for the assessment of iron overload and iron chelation in transfusion-dependent thalassemia major, sickle cell disease, and other congenital anemias. Intern Med J. 2011;41:516–24.CrossRefPubMed
Metadata
Title
Health-related quality of life in pediatric and adolescent patients with transfusion-dependent ß-thalassemia in upper Egypt (single center study)
Authors
Gehan L Abdel Hakeem
Suzan O Mousa
Asmaa N Moustafa
Mohamed H Mahgoob
Ebtesam E Hassan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-0893-z

Other articles of this Issue 1/2018

Health and Quality of Life Outcomes 1/2018 Go to the issue