Publication:

Health related quality of life and related factors among children with transfusion dependent thalassemia: a cross-sectional study in Chattogram, Bangladesh

Background Transfusion-dependent thalassemia (TDT) is a chronic inherited disorder requiring lifelong transfusions and iron chelation. Despite improved survival, complications and treatment burden reduce health-related quality of life (HRQoL). Evidence from Bangladesh using disease-specific tools is limited. This study assessed HRQoL and its associated factors among children with TDT in Chattogram.

Methods A cross-sectional study was conducted among 400 children (6–18 years) at two tertiary hospitals in Chattogram. HRQoL was measured using the Bangla-translated TranQol questionnaire (physical, emotional, family and school/career domains). Sociodemographic and clinical data were collected via interviews and records. Data were analyzed using non-parametric tests, correlation and hierarchical multiple linear regression in SPSS v27, with p<0.05 considered significant.

Results Most participants were aged 10–15 years (58.0%) and male (68.5%), with HbE thalassemia as the predominant type (70.0%). Mean serum ferritin was high (2082.6±1353.7 ng/ml) and 54.5% received iron chelation therapy. Physical health had the lowest HRQoL score (6.07/24), followed by family (11.32/36), emotional (14.13/36) and school/career (9.45/16). Sociodemographic and family factors explained 31.8%, 26.1%, 16.6% and 24.6% of variance across domains, respectively (all p<0.001). Age at diagnosis and residence were consistent significant predictors.

Conclusions Children with TDT in Bangladesh experience substantial multidimensional impairment in HRQoL. Early age at diagnosis, iron overload and socioeconomic constraints significantly influence outcomes. Integrating routine HRQoL assessment and strengthening psychosocial and financial support mechanisms are essential to improve holistic thalassemia care.