Background: Congenital hemoglobin defects are significant global health concern affecting more than 330,000 newborns every year. In Bangladesh, more than half of the under-five children are anemic, but the contribution of hemoglobin disorders to childhood anemia is quite unexplored. Therefore, the objective of the present study was to investigate the prevalence and pattern of hemoglobinopathies among anemic under-five (age 6-59 months) children visiting the hematology department of Rajshahi Medical College Hospital (RMCH).

Methods: This was a retrospective cross-sectional study among anemic patients aged between 6 to 59 months conducted in the hematology department of RMCH from July 2018 to June 2020. The guideline of WHO was used to define the severity of anemia. Hemoglobinopathies was measured using standard methods. Chi-square test was used to find the association between two categorical factors.

Results: We found that female and younger children were more likely to get moderate to severe anemic compared to their counterparts. Out of 534 patients 183 were suffering from different types of hemoglobinopathies (prevalence 34.3%). E-β-Thalassemia was the most common type of hemoglobinopathy (14%) followed by Hemoglobin E trait (11%) and β-Thalassemia minor (5.6%). Prevalence of these hemoglobin disorders was comparatively higher among female and older children (p<0.05). Patients with E-β-Thalassemia and β-Thalassemia major of our study were mostly suffering from severe form of anemia while patients with hemoglobin E trait and β-Thalassemia minor were mostly suffering from mild anemia (p<0.01).

Conclusions: A remarkable number of children were suffering from severe anemia and different types of hemoglobinopathies. Gender and age group were the risk factors of anemia and hemoglobinopathies among under-five children. Health authorities of Bangladesh should especially take care of anemic children in this country.