Primary immunodeficiency diseases (PIDD) are under-diagnosed in the Middle East/North Africa (MENA) Region. Reasons include lack of resources and immunologic expertise. The region is densely populated, and consanguineous mating is high, with rates exceeding 60% in some areas which allows for emergence of rare autosomal recessive disorders.
Human immunoglobulin preparations for intravenous or subcutaneous administration are the cornerstone of treatment in patients with primary immunodeficiency diseases affecting the humoral immune system. Unfortunately, not all patients with antibody deficiencies in the developing countries are privileged to have regular IVIG therapy due to the high cost of its products. Health authorities and governmental stakeholders should support immunoglobulin treatment and to consider such treatment a priority in maintaining optimal health service to those patients.
The main obstacle to hematopoietic stem cell transplantation (HSCT) in some countries in our region is financial. The probability to have an HLA matched donor used to be around 40% in our community owing to larger family size but as families are now getting smaller this percentage is decreasing. Less than 3% of donors listed in international registries are of oriental origin, which makes it difficult to find a match for our patients. Many patients also find it difficult to comply with post-transplant hygienic rules. Genetic counseling in PIDD, together with prenatal diagnosis, is of vast importance in management plans, especially in countries with a high prevalence of PIDD but limited resources.