Abstract

The incidence and etiology of aplastic anemia in Thailand will be investigated in a population-based case-control study. This includes an extension of an existing study in Bangkok and its expansion to two rural areas of Thailand, Khonkan and Songkla. All hospitals with at least 100 beds in Bangkok and its suburbs (population, 8.7 million) are already participating in the study. In the rural areas (total population, 9.6 million) all hospitals with at least 100 beds will be enrolled. Cases will be identified prospectively, and reviewed independently by a committee of hematologists to confirm the diagnoses. Suitable controls will be selected from among other patients in the same hospitals (e.g., patients with trauma and other acute conditions) and matched to cases for age, sex, and the time of hospitalization. All identified cases and controls will be interviewed to obtain information on drug use, occupational and chemical exposures, personal data, and relevant medical history. Serum and DNA samples will be collected from all cages and one control per case for analysis of hepatitis, Epstein-Barr, and other viruses. At the end of the study, there will be 330 cases and 1320 controls available for analysis. Incidence rates and the risk of aplastic anemia among individuals exposed to various factors will be estimated. Because of the population-based design, absolute as well as relative measures of risk will be provided. The preliminary results from the existing study suggest that aplastic anemia is, overall, overall, twice as common in Bangkok as in Western countries, and that it is much more common among young individuals. This is possibly due to environmental factors. An extension of the study will provide more information about the role of the drugs and other factors, especially household pesticides and various occupational exposures; expansion to the rural areas will make possible the evaluation of the role of pesticides used in agriculture, and other factors unique to rural Thailand.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL035068-05
Application #
3348591
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1988-09-30
Project End
1994-09-29
Budget Start
1992-09-30
Budget End
1993-09-29
Support Year
5
Fiscal Year
1992
Total Cost
Indirect Cost

  Institution

Name
Mahidol University
Department
Type
DUNS #
City
Nakhon Pathom
State
Country
Thailand
Zip Code
73170

  Publications

Issaragrisil, Surapol; Kaufman, David W; Anderson, Theresa et al. (2006) The epidemiology of aplastic anemia in Thailand. Blood 107:1299-307
Shapiro, S; Issaragrisil, S; Kaufman, D W et al. (1999) Agranulocytosis in Bangkok, Thailand: a predominantly drug-induced disease with an unusually low incidence. Aplastic Anemia Study Group. Am J Trop Med Hyg 60:573-7
Issaragrisil, S; Leaverton, P E; Chansung, K et al. (1999) Regional patterns in the incidence of aplastic anemia in Thailand. The Aplastic Anemia Study Group. Am J Hematol 61:164-8
Issaragrisil, S (1999) Epidemiology of aplastic anemia in Thailand. Thai Aplastic Anemia Study Group. Int J Hematol 70:137-40
Issaragrisil, S; U-pratya, Y; Yimyam, M et al. (1998) Hematopoietic progenitor cells in the blood and bone marrow in various hematologic disorders. Stem Cells 16 Suppl 1:123-8
Wiholm, B E; Kelly, J P; Kaufman, D et al. (1998) Relation of aplastic anaemia to use of chloramphenicol eye drops in two international case-control studies. BMJ 316:666
Issaragrisil, S; Chansung, K; Kaufman, D W et al. (1997) Aplastic anemia in rural Thailand: its association with grain farming and agricultural pesticide exposure. Aplastic Anemia Study Group. Am J Public Health 87:1551-4
Issaragrisil, S; Kaufman, D W; Anderson, T et al. (1997) Low drug attributability of aplastic anemia in Thailand. The Aplastic Anemia Study Group. Blood 89:4034-9
Kaufman, D W; Issaragrisil, S; Anderson, T et al. (1997) Use of household pesticides and the risk of aplastic anaemia in Thailand. The Aplastic Anemia Study Group. Int J Epidemiol 26:643-50
Issaragrisil, S; Kaufman, D; Thongput, A et al. (1997) Association of seropositivity for hepatitis viruses and aplastic anemia in Thailand. Hepatology 25:1255-7

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