A New Approach Based on Erythrocyte Indices to Exclude Normal Populations from Chromatography Based Thalassemia Screening Programs with Very High Fidelity
نویسندگان
چکیده مقاله:
Background: Screening and counselling is the most effective way to prevent the birth of children with thalassemia major. An accurate and relatively less time-consuming protocol is necessary to screen large populations. Separating iron deficiency anaemia from thalassemia trait based on blood cell parameters has been used by hematologists for many years. We aimed to design a new approach to screen the microcytic populations. Methods: Blood cell parameters and chromatography were used to screen the populations traditionally. Validating the result with a five-point decision tree analysis with two equations based on cut-off values of five blood cell parameters was performed. 2984 participants were screened traditionally, of which 289 were found to be beta-thalassemia trait, 63 were Hemoglobin E carriers, 15 were found to be Hemoglobin D (Hb D) Punjab, 4 hereditary persistent fetal hemoglobin (HPFH), and 14 belonged to beta thalassemia traits with HbA2 levels between 3.3% to 3.8% associated with reduced mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) (borderline cases). Results: In the decision tree approach, 51.3% with beta thalassemia trait and 11.65% Hb E carriers were detected perfectly. 27% of participants were detected as non-thalassemia carriers which could be excluded from further chromatographic analysis. Conclusion: During the early stages of the carriers screening program, a large portion of the sample could be excluded, based on segregating the IDA and thalassemia carrier population. Decision tree analysis and equation derived from the regression are essential to from limit of exclusion which implies significant cost reductions.
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عنوان ژورنال
دوره 13 شماره 4
صفحات 107- 118
تاریخ انتشار 2021-12
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