A systematic review of the prevalence and phenotypic characteristics of hemoglobin Malay in Southeast Asia
BACKGROUND: Hemoglobin (Hb) Malay is a β-globin variant associated with a β⁺⁺-thalassemia phenotype, resulting from a point mutation at codon 19 of the β-globin gene. Data on its prevalence and phenotypic characteristics remain fragmented. AIMS: This study aimed to determine the prevalence of H...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | en en |
| Published: |
Wolters Kluwer Health
2026
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| Subjects: | |
| Online Access: | https://irep.iium.edu.my/128492/7/128492_A%20systematic%20review%20of%20the%20prevalence.pdf https://irep.iium.edu.my/128492/8/128492_A%20systematic%20review%20of%20the%20prevalence_WOS.pdf https://irep.iium.edu.my/128492/ https://journals.lww.com/ijhm/fulltext/2026/01000/a_systematic_review_of_the_prevalence_and.2.aspx?context=latestarticles |
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| Summary: | BACKGROUND:
Hemoglobin (Hb) Malay is a β-globin variant associated with a β⁺⁺-thalassemia phenotype, resulting from a point mutation at codon 19 of the β-globin gene. Data on its prevalence and phenotypic characteristics remain fragmented.
AIMS:
This study aimed to determine the prevalence of Hb Malay and describe its phenotypic spectrum across different regions.
METHODS:
A systematic literature search was conducted using Medline (PubMed), CINAHL (EBSCOhost), and ScienceDirect. Relevant studies published from database inception to 2024 were screened according to predefined eligibility criteria. Meta-analysis was performed using Review Manager (RevMan) version 5.4. Pooled prevalence estimates were calculated, and outcomes were reported with corresponding 95% confidence intervals.
RESULTS:
Twenty-two studies involving 19,956 participants were included. Due to substantial heterogeneity among studies (I2 = 86%, P < 0.001), a random-effects model was applied. The overall pooled prevalence of Hb Malay was 3.53%. The highest prevalence was observed in Indonesia (12.18%), followed by Thailand (3.43%), Malaysia (3.02%), and Singapore (0.75%).
CONCLUSION:
This study represents the first comprehensive meta-analysis of Hb Malay prevalence and phenotypic characteristics over 30 years (1990–2024). Although Hb Malay is a relatively rare Hb variant largely confined to Southeast Asia, its clinical relevance is significant, particularly when coinherited with other β-thalassemia mutations, which may modify disease severity and increase transfusion requirements. These findings provide valuable evidence to inform regional thalassemia screening strategies and support targeted genetic counselling programmes |
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