ROLE OF DISCRIMINATION INDICES IN SCREENING OF BETA THALASSEMIA TRAIT IN LOW-RESOURCED AREAS OF PAKISTAN
Abstract
Introduction: Thalassemia is a common inherited hemoglobinopathy in Pakistan. Despite various preventive measures taken, each year around 5000 new cases are diagnosed. The problem occurs due to undiagnosed beta Thalassemia carriers. This is because of lack of massive screening programs and unavailability of hemoglobin electrophoresis in different cities of Pakistan. The aim of this study is to assess the sensitivity of different discriminating indices in screening of beta Thalassemia trait.
Method: The study was conducted at Pakistan Institute of Medical Sciences from Jan 2018-July 2018. All patients who were diagnosed as beta thalassemia trait through hemoglobin electrophoresis were included in the study. Seven discriminating indices were applied and sensitivity of each index was calculated.
Result: The male to female ratio was 1:1. 88% of the cases had a positive family history of Thalassemia. Among the various indices used, Shine and Lal showed a sensitivity of 100%, followed by Ricerca (96.6%) and Ehsani (92.58%). The sensitivities of Mentzer, Srivasta, RDWI and MCHD were 92.56%, 91.70%,79% and 70.9% respectively. The results of our study showed that Shine and Lal is the most sensitive index for screening beta Thalassemia trait.
Conclusion: Shine and Lal index is useful to the clinicians as an initial screening tool of beta thalassemia trait. Such cases can then be referred to laboratories where hemoglobin electrophoresis facility is available.
Keywords: Beta Thalassemia, Thalassemia trait, Discriminating Indices, Iron deficiency Anemia, microcytic hypochromic Anemia, Hemoglobin electrophoresis.