1887
Volume 2013, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Inborn errors of metabolism (IEM) are mostly transmitted as autosomal recessive disorders and are therefore more frequent in countries with high consanguinity rates such as in the Arab world. To study the socio-demographic characteristics and the clinical presentation of IEM in Libyan children and to shed light on our experience in dealing with these disorders. This is a descriptive case series hospital-based study of 107 children attending the Metabolic Unit at El-Khadra Teaching Hospital (MUKH) in Tripoli, Libya. The study took place between January 2001 and December 2012. Information was collected from caregivers and from all available hospital records on the following variables: age, sex, birth order, place of residence, age at onset, presenting complaints and family history of the same illness. During the 12-year study period, there were 55,422 live births at El-Khadra Teaching Hospital and 107 children were diagnosed with 46 different metabolic disorders. A significantly high consanguinity rate was observed (86.9%) among parents of the affected children. Family history of previous affected children was noted in 63.5% of cases. Male to female ratio was 1.18:1. The most frequent IEM cases were amino acids disorders (25%), carbohydrate disorders (14.9%), lysosomal storage diseases (14%), organic aciduria and energy metabolic defects (9.3% each). The main clinical presentations were jaundice, hepatomegaly and seizures. Most children presented between one and six months of age (43.4%); whereas the median age at diagnosis was eight months. Thirty-eight children (35.5%) were born at El-Khadra Hospital with IEM giving a birth prevalence of 1:1458 live births, (1:6158 for aminoaciduria and 1:6927 for carbohydrate disorders). IEM disorders are common in Libya. Efforts to enhance awareness among pediatricians and primary healthcare providers should be supported and encouraged as many diseases are still undiagnosed. It is very important to consider IEM among all children when they present any worrying or suspicious symptoms or signs which do not respond to conventional treatment. Although our findings are preliminary, and probably the first to be conducted in Libya, they suggest ideas for decision makers to plan services including newborn screening programs and country-wide research of IEM diseases.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2013.18
2014-04-01
2024-12-26
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2013/2/qmj.2013.18.html?itemId=/content/journals/10.5339/qmj.2013.18&mimeType=html&fmt=ahah

References

  1. Ben Omran T. Genetic disorders in Libya. In: Ahmad TS, ed. Genetic disorders among Arab populations. 2nd ed. Berlin Heidelberg: Springer-Verlag 2010;:444445.
    [Google Scholar]
  2. Alobaidy H, Kreasta M, Dekna M, Juma MR. Perinatal Mortality and Morbidity at Elkhadra Hospital Tripoli Libya. JMJ. 2004; 3:1:4851.
    [Google Scholar]
  3. Abushhaiwia AME, Ziyani MMN, Dekna M. Mortality in the special care baby unit of the main children's hospital in Tripoli Libyan Arab Jamahiriya. East Mediterr Health J. 2010; 16:11:11371142.
    [Google Scholar]
  4. Social Indicators. United Nation Statistical Division. (Internet). Update June 2011. Available from: http://unstats.un.org/unsd/demographic/products/socind/health.htm .
  5. Broadhead RL, Sehgal KC. Consanguinity and congenital abnormalities in East Libya. Garyounis Med J. 1981; 4::35.
    [Google Scholar]
  6. Wilcken B. Expanded newborn screening: reducing harm, asserting benefit. J Inherit Metab Dis. 2010; 33::205210.
    [Google Scholar]
  7. Saadallah AA, Rashed MS. Newborn screening: Experiences in the Middle East and North Africa. J Inherit Metab Dis. 2007; 30::482489.
    [Google Scholar]
  8. Krotoski D, Namasta S, MHS , Raouf RK, El Nekhely I, Hindi-Alexander M, Engelson G, Hanson JW, Howell RR. Conference report: Second conference of the Middle East and North Africa newborn screening initiative: Partnerships for sustainable newborn screening infrastructure and research opportunities. Genet Med. 2009; 9::16.
    [Google Scholar]
  9. Abdel-Hamid M, Tisocki K, Sharaf L, Ramadan D. Development, validation and application of tandem mass spectrometry for screening of inborn metabolic disorders in Kuwaiti infants. Med Princ Pract. 2007; 16:3:215221.
    [Google Scholar]
  10. Hadg-Taieb S, Naasrallah F, Hammami MB, Elasmi M, Sanhaji H, Moncef F, Kaabachi N. Aminoacidopathies and organic aciduria in Tunisia: a retrospective survey over 23 years. Tunis Med. 2012; 90::259262.
    [Google Scholar]
  11. Al-Gazali L, Hamamy H, Al-Arrayad S. Genetic disorders in the Arab world. BMJ. 2006; 333:21:831834.
    [Google Scholar]
  12. Olayiwola N. /Staff Reporter. Neonatal screening ‘helps prevent impaired growth’ [Newborn screening in India web site]. Available at: http:// www.NeoGenLabs.com, posted by Neha on November 2, 2012.
  13. Moammar H, Cheriyan G, Mathew R, Al-Sanaa N. Incidence and patterns of inborn errors of metabolism in the Eastern province of Saudi Arabia, 1983–2008. Ann Saudi Med. 2010; 30:4:271277.
    [Google Scholar]
  14. Joshi SN, Hashim J, Venugopalan P. Pattern of inborn errors of metabolism in an Omani population of the Arabian Peninsula. Ann Trop Peadiat. 2002; 22::9396.
    [Google Scholar]
  15. Hassan F, Mougy FE, Mandour I, Abdel Hady S, Selim L, Abdel Atty S, Morgan M, Salem F, Oraby A, Mehaney D, Abdel Monem M, El Nekhely I, Moharam N. Preliminary results of Egypt experience for use of Tandem Mass Spectrometry for expanded metabolic screening. J Appl Sci Res. 2009; 5::14251435.
    [Google Scholar]
  16. Barton L, Hodgman JE. The contribution of withholding or withdrawing care to newborn mortality. Pediatrics. 2005; 116:6:14871491.
    [Google Scholar]
  17. Aoki K. Long term follow-up of patients with inborn errors of metabolism detected by the newborn screening program in Japan. Southeast Asian J Trop Med public health. 2003; 34:suppl 3:1923.
    [Google Scholar]
/content/journals/10.5339/qmj.2013.18
Loading
/content/journals/10.5339/qmj.2013.18
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): consanguinityinborn errors of metabolism and Libya
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error