Annals of Clinical and Laboratory Research

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Determination of Efficacy and Reliability of Various Discrimination Indices in Screening Beta Thalassemia Trait

Saima Khan1 *, Sayeedul Hasan Arif2 , Zeba Zaka-urRab3 and Mahboob Hassan2

Background: Beta-thalassemia trait (βTT) is a common hemoglobinopathy and imposes a significant burden on the global healthcare. Screening of this disorder is immensely important as it can significantly reduce the future incidence of thalassemia major. This study was conducted in order to evaluate the role of discrimination indices to differentiate cases of βTT from other causes of microcytic anemia.

Materials and Methods: A single-center study was carried out on 1600 subjects reported during November 2015 to November 2017.Tests for serum iron and ferritin were also conducted in individuals showing low MCV. All the selected samples were subjected to complete blood counts and blood morphology. Cellulose acetate alkaline electrophoresis and iron profile were carried out to differentiate IDA and beta thalassemia trait. Comparison of various parameters and discrimination indices were calculated for all the samples.

Results: Shine and Lal index, Mentzer index and red cell distribution width index had revealed better discriminative function compared to England and Fraser index, Srivastava index, and Green and King Index.

Conclusion: Though HbA2 estimation is the gold standard for diagnosing βTT, in developing countries, discrimination indices are rapid, reliable and easy tools to screen cases of βTT and send the subject for further electrophoresis and high performance liquid chromatography evaluation.