Primary Immunodeficiencies: Epidemiology in the Maghreb
##plugins.themes.academic_pro.article.main##
Abstract
Introduction: Primary Immunodeficiency (PIDs) is a set of 330 rare hereditary diseases that increase susceptibility to infections, allergies, autoimmunity, and neoplasia. North American registries give higher prevalence than Maghreb ones, whereas consanguinity is high. The purpose of this study is to compare prevalence and coverage rate of Maghreb PID registries with estimates based on USA.
Methods: We searched the prevalence of PIDs in the Maghreb registers. Next, we estimated the expected values based on recent publications. Finally, we calculated the coverage rate of the Maghreb registries compared to the new estimates and we evaluated the impact of consanguinity.
Results: The total number is N1 = 2456 patients. The current Maghreb PID Prevalence is 2.56 / 100,000 inhabitants (population of 94,804,694 Million in 2017). Tunisia leads with a prevalence of 8.70 followed by Morocco 2.09, Libya 1.65 and Algeria 1.46/100.000 habitants. We did not find values for Mauritania. If we extrapolate the prevalence of the USA to the Maghreb population, the number of patients in the Maghreb would be N2 = 27,588 and the coverage rate (N1 / N2) would be 8.90%. This low coverage rate is however better than the World average (1.21%), that of Latin America 1.19% and Africa 0.36%. The Maghreb prevalence is close to that of the Arab world 2.04 / 100,000 (population of 391,449,544 in 2017). Using the incidence found in the USA, the number of patients would be 9765 new patients per year in the Maghreb and 40,319 in Arab countries.
Conclusion: PID Maghreb patients number is very low compared to global estimates, whereas consanguinity is very high. Special attention should be given to PIDs by governments and research teams in this region.
Keywords:
Immunologic Deficiency Syndromes - Genetics - Epidemiology - Africa, Northern.##plugins.themes.academic_pro.article.details##
References
- Bousfiha A, Jeddane L, Picard C, Ailal F, et al., The 2017 IUIS Phenotypic Classification for Primary Immunodeficiencies. J Clin Immunol. 2018, 38: 129-143.
- Anwar WA, Khyatti M, Hemminki K. Consanguinity and genetic diseases in North Africa and immigrants to Europe. Eur J Public Health. 2014,24 Suppl 1:57-63
- Bustamante J, Boisson-Dupuis S, Abel L, Casanova JL, Mendelian susceptibility to mycobacterial disease: genetic, immunological, and clinicalfeatures of inbornerrors of IFN-γ immunity. SeminImmunol. 2014, 26:454-70.
- Ellis MK, Elliott KS, Rautanen A, Crook DW, Hill AV, Chapman SJ, Rare variants in MYD88, IRAK4 and IKBKG and susceptibility to invasive pneumococcal disease: a population-based case-control study. PLoS One 2015,4:10.
- Casrouge A, Zhang SY, Eidenschenk C, Jouanguy E, Puel A, Yang K, et al. Herpes simplex virus encephalitis in human UNC-93B deficiency. Science 2006, 314 :308-12.
- Barbouche MR, Galal N, Ben Mustapha I, Bousfiha AA, Ailal F, Bejaoui et al. Primary immunodeficiencies in highly consanguineous NorthAfrican populations. Ann N Y Acad Sci. 2011, 1238: 42-52.
- Al-Herz W. Primary immuno deficiency disorders in Kuwait: first report from Kuwait National PrimaryImmunodeficiencyRegistry (2004--2006). J Clin Immunol. 2008, 28:186-93
- Mellouli F, Mustapha IB, Khaled MB, Besbes H, Ouederni M, Mekki N, et al. Report of the TunisianRegistry of Primary Immunodeficiencies: 25-Years of Experience (1988-2012). J Clin Immunol. 2015, 35:745-53
- Al-Saud B, Al-Mousa H, Al Gazlan S, Al-Ghonaium A, Afzal J, Al-Dhekri H, et al. Primary Immuno deficiency Diseases in SaudiArabia: a Tertiary Care Hospital Experience over a Period of Three Years (2010-2013). J Clin Immunol. 2015, 35: 651-60.
- Al Muhsen S, Alsum Z. Primary immunodeficiency diseases in the Middle East. Ann N Y Acad Sci. 2012, 1250:56-61.
- Al-Tamemi S, Elnour I, Dennison D. PrimaryImmunodeficiency Diseases in Oman: 10-Year Experience in a Tertiary Care Hospital. J Clin Immunol. 2016, 36:785-792
- Ehlayel MS, Bener A, Laban MA. Primaryimmunodeficiency diseases in children: 15-year experience in a tertiary care medical center in Qatar. J Clin Immunol. 2013, 33:317-24.
- Baghriche M. Smati L, El Yagoubi A., et al. Introduction To PrimaryImmunodeficiency Diseases In Algeria. Revue Algérienne d'Immunologie et d'Immunopathologie 2015, Suppl Mai
- Kobrynski L, Powell RW, Bowen S. Prevalence and morbidity of primaryimmunodeficiency diseases, United States 2001-2007. J Clin Immunol. 2014, 34:954-61.
- Joshi AY, Iyer VN, Hagan JB, Sauver JLS, Boyce TG. Incidence and temporal trends of primaryimmunodeficiency: a population-based cohort study. Mayo Clin Proc. 2009, 84:16-22.
- Al-Herz W1, Aldhekri H, Barbouche MR, Rezaei N. Consanguinity and primary immunodeficiencies. Hum Hered 2014, 77:138-43.
- Bousfiha AA, Jeddane L, Dakkoune M . PID Epidemiology in Arab World. Moroccan Health Journal 2015, 12: 8-13.
- Al-Mousa H, Al-Dakheel G, Jabr A, Elbadaoui F, Abouelhoda M, Baig M, Monies D, Meyer B, Hawwari A, Dasouki M. High Incidence of Severe Combined Immunodeficiency Disease in Saudi Arabia Detected Through Combined T Cell Receptor Excision Circle and Next Generation Sequencing of Newborn Dried Blood Spots. Front Immunol. 2018, 16, 9:782.