Genetic counseling for thalassemia in Thailand: problems and solutions

Thalassemia, a hereditary anemia, has been a major public health problem in Thailand and Southeast Asia for decades, yet the prevalence of thalassemia in Thailand is not decreasing due to lack of awareness of this disease in Thai population, which implied that genetic counseling was a failure. We determined the problems and obstacles in thalassemia counseling in Thailand and proposed the possible solutions in order to deliver genetic counseling and services to the communities more efficiently. A survey in thalassemia services was carried out in 12 hospitals; 9 in Bangkok, 3 in the North, Northeast, and South of Thailand respectively, by using questionnaire designed to assess the healthcare system, characteristics of target population, methods of genetic counseling, knowledge and attitudes of counselors, thalassemia support group, and researches in thalassemia, in a cross-sectional descriptive research design. The main problems in genetic counseling for thalassemia in Thailand are the followings; thalassemia problems not visible to the administrators, unorganized teamwork and services, lack of knowledge and inadequate numbers of counselors, lack of thalassemia support group, and inadequate researches in thalassemia prevention and control. The possible solutions are proposed. This study has pointed out the unseen problems and obstacles, along with the solutions in genetic counseling, given correctly, will help create awareness of thalassemia impact on health and socioeconomics in the Thai population. Thus, genetic counseling, with well-established guidelines, is a critical component for the success of prevention and control of thalassemia in Thailand.