This Series paper synthesizes thalassaemia epidemiology across 10 countries in WHO's South-East Asia Region by combining local expertise with a rapid literature review. Alpha- and beta-globin disorders and haemoglobin E are frequent and produce phenotypes ranging from asymptomatic carriage to lifelong transfusion dependence. Although a small set of mutations often dominates within each country, the regional spectrum is complex and population data remain incomplete. The paper highlights blood shortages, consanguinity in some settings, gender inequities, migration, and low awareness, and recommends national registries, premarital or prenatal screening, coordinated blood systems, and culturally sensitive education.
Key findings
- Alpha- and beta-thalassaemia variants and HbE are frequent across the region, with clinical consequences ranging from asymptomatic carriage to regular transfusion dependence.
- A few mutations often predominate within a country, yet the combined spectrum is complex and epidemiological data are limited in many settings, obstructing accurate service-need estimates.
- Recurring system and social challenges include inadequate blood supply, weak diagnosis and registries, low awareness, gender inequity, consanguinity in some communities, and migration that redistributes variants.
Why this matters globally
Registries linking diagnosis, severe births, blood demand, and long-term outcomes would support planning and prevention evaluation better than fragmented prevalence figures. Screening and counselling must be voluntary, non-directive, reproductive-rights-respecting, and equitable. Advanced treatments including gene therapy may transform outcomes for some, but without reliable transfusion, chelation, diagnosis, and financing, new technology could widen inequity.
Thai researcher contribution
Suthat Fucharoen and Kittiphong Paiboonsukwong of Mahidol University's Thalassemia Research Center contributed Thai evidence and perspective; Fucharoen also listed Samitivej Srinakarin Hospital. Thai expertise in HbE/beta-thalassaemia, genetic mapping, and screening systems therefore informs this regional synthesis.
Limitations to consider
This is a rapid review informed by experts, not a systematic review or meta-analysis. Sources vary in year, population, case definition, laboratory method, and coverage. Incomplete registries and diagnosis create under-ascertainment, so country prevalence figures should not be ranked directly. National summaries can obscure ethnic, subnational, gender, and socioeconomic differences; migration makes static maps age quickly; and the paper does not experimentally compare screening, registry, or treatment programmes.