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Inherited haemoglobin disorders (sickle-cell disorders and thalassaemias) were originally characteristic of the tropics and subtropics but are now common worldwide due to migration. Haemoglobin disorders were originally endemic in 60% of 229 countries, potentially affecting 75% of births, but are now sufficiently common in 71% of countries among 89% of births (either in the whole population or among minorities) to require policy-makers to consider the most appropriate strategy for treatment and prevention.
At least 5.2% of the world population (and over 7% of pregnant women) carry a significant variant. Haemoglobin S accounts for 40% of carriers but causes over 80% of disorders because of localized very high carrier prevalence: around 85% of sickle-cell disorders, and over 70% of all affected births occur in Africa. In addition, at least 20% of the world population carry α+ thalassaemia.
Oral submucous fibrosis (OSMF) is a chronic, progressive, scarring precancerous condition of the oral cavity seen predominantly in the Indian subcontinent and South East Asia. In India, the prevalence increased over the past four decades from 0.03% to 6.42%. Data published earlier reported an estimate of 5 million OSMF patients in India. OSMF is seen commonly in males between 20 and 40 yrs age.
The common sites involved are buccal mucosa, labial mucosa, retromolar pads, soft palate and floor of the mouth. Rarely fibrotic changes of the pharynx, esophagus and paratubal muscles of eustachian tubes have also been observed. OSMF leads to difficulty in swallowing, speech & hearing defects and defective gustatory sensation.
The World Health Organization (WHO) estimates that 60 to 80 million couples worldwide currently suffer from infertility. Infertility varies across regions of the world and is estimated to affect 8 to 12 per cent of couples worldwide.
Underlying these numbers exists a core group of couples, estimated to be 3 to 5 per cent, who are infertile due to unknown or unpreventable conditions. A prevalence of infertility above this level suggests preventable or treatable causes.
Skin Allergy and Eczema
Atopic dermatitis (AD), also called atopic eczema, is a common chronic or recurrent inflammatory skin disease and affects 15-20% of children and 1-3% of adults worldwide. It is characterized by acute flare-ups of eczematous pruritic lesions over dry skin. Eczema is more common in females than males. Hospitalization due to AD flares and associated infections and/or viruses is associated with an 8-year reduction in lifespan.