The spatial epidemiology of sickle-cell anaemia in India.

摘要: Sickle-cell anaemia (SCA) is a neglected chronic disorder of increasing global health importance, with India estimated to have the second highest burden disease. In country, SCA particularly prevalent in scheduled populations, which comprise most socioeconomically disadvantaged communities. We compiled geodatabase substantial number surveys carried out over last decade. Using generalised additive models and bootstrapping methods, we generated first India-specific model-based map sickle-cell allele frequency accounts for district-level distribution non-scheduled populations. Where possible, derived state- estimates newborns 2020 two groups. Through inclusion an additional 158 data points 1.3 million individuals, considerably increased amount our mapping evidence-base compared previous studies. Highest predicted frequencies up 10% spanned central India, whilst hotspot ~12% was observed Jammu Kashmir. Evidence heavily biased towards populations remained limited can lead considerable uncertainties newborn at national state level. This has important implications policy planning. By taking population composition into account, maps that better reflect complex epidemiology turn provide more reliable its vast country. work supported by European Union’s Seventh Framework Programme (FP7//2007–2013)/European Research Council [268904 – DIVERSITY]; Newton-Bhabha Fund [227756052 CH]