Abner R. Robinson

Thalassaemia in Liberia

The tribes of central and south-eastern Liberia have been shown to differ strikingly from the tribes of such near-by areas as Sierra Leone and Ghana in the low frequency of the haemoglobin C trait (Neel et al., 1956) and the sickle-cell trait (Livingstone, 1958). Furthermore, 7 out of 904 Liberians, representing all of the tribes of that country, whose haemoglobin was analysed electrophoretically were found to have haemoglobin N (Liberian I haemoglobin; Robinson et al., 1956), a type of haemoglobin reported since then in only two other Africans, one from Ghana and one from Nigeria (Ager and Lehmann, 1958). All but one of these seven individuals were from the Mande-speaking tribes of central Liberia (Loma, Kpelle, Mano, Gio); in these tribes the frequency of individuals possessing haemoglobin N was about 2%. This note records additional unusual haematological observations made by us among some of the tribes of central and south-eastern Liberia. A number of children with intractable anaemias and massive splenomegaly have been seen in the past several years at the hospital maintained by the Firestone Company at its rubber plantation in south-eastern Liberia. This report is concerned with two of these children who, after treatment for malaria and intestinal parasites, underwent splenectomies. The first child (Wle), a 5-year-old boy, exhibited a severe anaemia with the characteristics of thalassaemia major. Blood films obtained in March and July, 1958, revealed striking leptocytosis, anisocytosis, microrytosis, poikilocytosis, and normoblastaemia (Fig. 1). While the interpretation of this blood picture is complicated by the fact that it was obtained after splenectomy, the morphology