What is thalassemia?
Thalassemia is an inherited blood disorder that affects the body's ability to make hemoglobin, the substance that carries oxygen in red blood cells. When hemoglobin is deficient or faulty, a person develops anaemia of varying degrees.
There is an important difference between a carrier (thalassemia minor) and a person with the disease (thalassemia major). A carrier is usually completely healthy and may only know through a test. A person with thalassemia major suffers severe anaemia from childhood and may need regular blood transfusions and lifelong treatment.
Why is thalassemia common in Syria?
Thalassemia is common across the Mediterranean and Near East region, and it is among the most prominent inherited disorders in Syria. Estimates suggest that about 5% of the population carry the beta-thalassemia trait, with higher concentrations in some areas such as rural Damascus, Aleppo, and the coast.
Two factors combine in Syria to raise the disease's prevalence: a high share of carriers, and the frequency of cousin marriage, which increases the chance of two carriers from the same family meeting. This is why awareness and early screening remain the cornerstone of reducing new cases.
- Thalassemia is among the most prominent inherited disorders in Syria.
- Estimates suggest about 5% of the population carry the beta trait.
- Higher concentrations in areas such as rural Damascus, Aleppo, and the coast.
- National thalassemia centers provide care for patients.
How is thalassemia inherited?
Thalassemia is a recessive inherited disorder, meaning a child needs a faulty copy of the gene from both parents to develop the full disease. If only one parent is a carrier, the children may be healthy carriers and do not develop the major disease.
If both parents are carriers, then with each pregnancy there is a 25% chance of a child with thalassemia major, a 50% chance of a healthy carrier child, and a 25% chance of a child who carries nothing. These probabilities recur independently with each pregnancy and do not change based on the number of previous children.
The role of cousin marriage
Cousin marriage is common in Syria, as in many communities of the region. Studies indicate that roughly a third of urban unions and close to four in ten rural unions are between relatives, and that marriage between paternal or maternal cousins is the most common among them.
Relatives share a larger portion of their genes, so the chance that both partners carry the same trait rises. This does not mean cousin marriage is wrong or forbidden. It means that premarital screening becomes even more important in this case, so that decisions are made with knowledge and awareness.
The importance of premarital screening and genetic counselling
Detecting carriers is easy and available: a full blood count reveals initial indicators, and hemoglobin electrophoresis confirms carrier status accurately. Doing this test before marriage gives the couple valuable information before starting a family.
If both partners turn out to be carriers, genetic counselling explains the available options and probabilities, without imposing a decision. The goal is not to prevent marriage, but to empower people to make an informed choice, and to reduce the number of affected children who need lifelong treatment.
- A full blood count as a first step reveals indicators.
- Hemoglobin electrophoresis confirms carrier status.
- Genetic counselling explains the probabilities and options.
- Early screening reduces new cases and eases the disease burden.
A message of awareness
Thalassemia is a disease whose new cases can be reduced greatly through awareness and screening, as happened in several countries in the region that implemented premarital screening programs. The step starts with a simple piece of information that every person about to marry should know.
At the same time, people living with thalassemia deserve every support, care, and a dignified life. Remember that this article is for general awareness only, and any medical or genetic decision should be made with the advice of a specialist doctor and a genetics counselor.
The Sihtak app helps you keep your test results in one place, including a full blood count and hemoglobin electrophoresis, to carry with you wherever you go. Ask the AI assistant what the word carrier means in simple words before you visit a doctor or a genetics counselor, and keep a family health record that makes tracking inherited conditions clearer for you and your doctors.
Frequently asked questions
Is a thalassemia carrier sick?
Usually not. A carrier (thalassemia minor) is generally completely healthy and may live life without knowing, discovering it only through a blood test. The full disease (thalassemia major) appears when the trait is inherited from both parents.
If my fiance and I are both carriers, does that mean we cannot marry?
No. Being carriers does not prevent marriage, but it means genetic counselling is important to understand the probabilities and available options, so you can make an informed, considered decision with a specialist doctor.
What test is needed before marriage?
Usually a full blood count as a first step, followed if needed by hemoglobin electrophoresis to confirm carrier status. The doctor guides you to the appropriate test and interprets the result.
Why does cousin marriage raise the risk of thalassemia?
Because relatives share a larger portion of their genes, the chance that both partners carry the same trait rises, and so does the chance of having an affected child. This is why premarital screening becomes more important in this case.
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This content is for health education only and is not a substitute for medical advice. If you have symptoms that worry you, see your doctor.