Burden of hemoglobinopathies and hemolytic anemias in the World Health Organization African region, 2000–2021: Findings from the Global Burden of Disease 2021 study

Hemoglobinopathies and hemolytic anemias (HHA) are genetic blood disorders associated with diverse clinical complications, affecting an estimated 2.1 billion people worldwide. The World Health Organization (WHO) African Region accounts for approximately 425.8 million individuals, or 20% of the global HHA prevalence, yet comprehensive assessments of this burden have been lacking. We present the first systematic analysis of HHA burden in the WHO African Region from 2000-2021 using data from the Global Burden of Disease (GBD) 2021 study. We estimated regional, sex-, and age-specific rates (per 100,000 population) of mortality, incidence at birth, and years lived with disability (YLDs) in five-year intervals. Mortality estimates were generated using the Cause of Death Ensemble model (CODEm), supplemented with spatiotemporal Gaussian process regression. Incidence at birth was estimated using DisMod-MR 2.1, a Bayesian meta-regression tool, while YLDs were calculated by multiplying prevalence by disability weights reflecting severity and duration. Between 2000 and 2021, the WHO African Region experienced persistently higher age-standardized death rates from HHA compared to global levels, although regional mortality declined over the period. Sickle cell disorder (SCD) was the predominant contributor, with the highest mortality [3.68 deaths (95% UI 2.04-6.29) per 100,000] and disability burden [41.08 YLDs (95% UI 26.09-58.61)], while thalassemias contributed the least. Disability-adjusted life years (DALYs) were concentrated in western sub-Saharan Africa, accounting for 71.3% of the regional burden. Age-specific estimates revealed that children under five years faced a disproportionate share of mortality and disability. Despite overall declines in mortality, the WHO African Region continues to bear a disproportionate global burden of HHA, particularly affecting young children. These findings underscore the urgent need for strengthened newborn screening, early treatment, and health system interventions to reduce preventable deaths and disability.

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PLOS Global Public Health
Published
2025-09-22
DOI
https://doi.org/10.1371/journal.pgph.0005197
Citations
1
Primary Topic
Hemoglobinopathies and Related Disorders
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article
Field-Weighted Citation Impact
1.63
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article

Burden of hemoglobinopathies and hemolytic anemias in the World Health Organization African region, 2000–2021: Findings from the Global Burden of Disease 2021 study

Andi Mai, Carly Malburg, Nicholas J Kassebaum, Gashaw Dessie et al.
1 citations
PLOS Global Public Health
Hemoglobinopathies and Related Disorders
1.63
article

Burden of hemoglobinopathies and hemolytic anemias in the World Health Organization African region, 2000–2021: Findings from the Global Burden of Disease 2021 study

Andi Mai, Carly Malburg, Nicholas J Kassebaum, Gashaw Dessie, Adeniyi Francis Fagbamigbe, Teferi Gebru Gebremeskel, Christopher Imokhuede Esezobor, Mayowa Ojo Owolabi, Woldeteklehaymanot Kassahun, Shimelis Tadesse, Robel Hussen Kabthymer, Farha Islam, Fitsum Wolde Demisse, Mengistie Diress, Osaretin Christabel Okonji, Segun Emmanuel Ibitoye, Prince M. Amegbor, Deborah Adenikinju, Haftu Asmerom, Sefineh Fenta Feleke, Berhanu Woldu, Ganiyu Adeniyi Amusa, Emmanuel Kwame Peprah, Habitu Birhan Eshetu, Seth Christopher Yaw Appiah, Richard Gyan Aboagye, Isaac Sunday Chukwu, Joyce Gyamfi, Biruk Getahun Kibret, Tadesse Asmamaw Dejenie, Temitope Tabitha Ojo, Prof Léon Muepu M Tshilolo
article en
1 citations

Abstract

Hemoglobinopathies and hemolytic anemias (HHA) are genetic blood disorders associated with diverse clinical complications, affecting an estimated 2.1 billion people worldwide. The World Health Organization (WHO) African Region accounts for approximately 425.8 million individuals, or 20% of the global HHA prevalence, yet comprehensive assessments of this burden have been lacking. We present the first systematic analysis of HHA burden in the WHO African Region from 2000-2021 using data from the Global Burden of Disease (GBD) 2021 study. We estimated regional, sex-, and age-specific rates (per 100,000 population) of mortality, incidence at birth, and years lived with disability (YLDs) in five-year intervals. Mortality estimates were generated using the Cause of Death Ensemble model (CODEm), supplemented with spatiotemporal Gaussian process regression. Incidence at birth was estimated using DisMod-MR 2.1, a Bayesian meta-regression tool, while YLDs were calculated by multiplying prevalence by disability weights reflecting severity and duration. Between 2000 and 2021, the WHO African Region experienced persistently higher age-standardized death rates from HHA compared to global levels, although regional mortality declined over the period. Sickle cell disorder (SCD) was the predominant contributor, with the highest mortality [3.68 deaths (95% UI 2.04-6.29) per 100,000] and disability burden [41.08 YLDs (95% UI 26.09-58.61)], while thalassemias contributed the least. Disability-adjusted life years (DALYs) were concentrated in western sub-Saharan Africa, accounting for 71.3% of the regional burden. Age-specific estimates revealed that children under five years faced a disproportionate share of mortality and disability. Despite overall declines in mortality, the WHO African Region continues to bear a disproportionate global burden of HHA, particularly affecting young children. These findings underscore the urgent need for strengthened newborn screening, early treatment, and health system interventions to reduce preventable deaths and disability.

PLOS Global Public HealthVol. 5(9)
Haramaya University (ET), University of Jos (NG), Flinders University (AU), Mahaveer Academy of Technology and Science University (IN), University of Ibadan (NG), University of Lagos (NG), University of Washington (US), University of Health and Allied Sciences (GH), University College Hospital, Ibadan (NG), Lagos University Teaching Hospital (NG), University of Mbuji Mayi (CD), Kwame Nkrumah University of Science and Technology (GH), Institute for Health Metrics and Evaluation (US), Institut Facultaire des Sciences de l'Information et de la Communication (CD), Federal Medical Centre (NG), Indiana University Bloomington (US), National Institute of Biomedical Research (CD), Dilla University (ET), Jos University Teaching Hospital (NG), Applied Behavioral Research (United States) (US), Woldia University (ET), Arba Minch University (ET), Bahir Dar University (ET), New York University (US), Coventry University (GB), Aksum University (ET), Ludwig-Maximilians-Universität München (DE), University of the Western Cape (ZA), University of Gondar (ET)
Openalex Percentile: Top 13%
Hemoglobinopathies and Related Disorders
1.63
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