Screening of thalassemia hemoglobin E in Maharat Nakorn Ratchasima Hospital
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Abstract
Background: Thalassemia Hb E was the most frequent single gene disorder in Thai population. If Hemoglobin E carriers get married with (-thalassemia carriers can produce diseased offspring. Hemoglobin E screening test was importance to search for Hemoglobin E carrier’s people.
Objective: To evaluate Hemoglobin E screening test (osmotic fragility test (OF,mean corpuscular volume (MCV) and dilchlorophenolindolphenol (DCIP) in Maharat Nakhom Ratchasima Hospital.
Patients and method: A retrospective data, from 1,166 non-anemic screened thalassemia persons who attended in Maharat Nakomratchasima Hospital from January 2006 to June 2010. All 1,166 non-anemic persons were screening thalassemia by osmotic fragility test (OF), mean corpuscular volume (MCV), dilchlorophenolindolphenol (DCIP) and confirmatory test by hemoglobin typing.
Results: Of 1,166 non-anemic screened persons, 746(62.27%) were heterozygous Hb E(EA), 311 (25.96%) were A2A and 110(9.18%) were homozygous Hb E(EE). Sensitivity, specificity, positive predictive value, negative predictive value of DCIP for screening thalassemia HbE carrier were 91.4% 83.6%, 93.94%, 80%, respectively. Using MCV <80 fL for screening thalassemia HbE carrier were better than OF. The sensitivity, specificity, positive predictive value, negative predictive value of MCV <80 fL and OF were 73.1%, 61.74%, 84.01%, 45.50% and 69.47%, 15.76%, 69.39%, 15.81%, respectively. The combination of DCIP and MCV <80 fL were similar sensitivity were 99.65% and 98.25%, respectively, but improve false positive rate if compare between DCIP alone, DCIP and OF, DCIP and MCV <80 fL were 20%, 13.04%, 8.98%, respectively.
Conclusion: Heterozygous Hb E (EA) was the most frequent in this study. DCIP was the best screening test for thalassemia Hb E. Combination between DCIP, OF and DCIP, MCV(<80fL) were improve sensitivity rate nearly 100%
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References
Wasi P, Pootrakul S, Pootrakul P, Pravatmuang P, Winichagoon P, Fucharoen S. Thalassemia in Thailand. Ann N Y Acad Sci 1980; 344: 352-63.
Wasi P. Haemoglobinopathies including thalassaemia. Part 1: Tropical Asia. Clin Haematol 1981; 10: 707-29.
Kanokpongsakdi S, Winichagoon p, Fucharoen S. Control of thalassemia in Southeast Asia. J Paediatr Obstet Gynecol 1990 : 16 (Suppl) : 9-14.
สุทัศน์ ฟูเจริญ, ปราณี ฟูเจริญ, Thalassemia in Thailand : problem and prenatal diagnosis. ใน : เสาวคนธ์ อัจจิมากร, เฉลิมศรี ธนันตเศรษฐ, บรรณาธิการ. การวินิจฉัยและรักษาทารกในครรภ์. กรุงเทพมหานคร : บริษัทพิมพ์ดี จำกัด, 2535 : 90-9.
วิจารณ์ พาณิช. คำแนะนำปรึกษาทางพันธุศาสตร์สำหรับธาลัสซีเมีย. สงขลานครินทร์เวชสาร 2534; 9: 221-34.
วิชัย เหล่าสมบัติ. ธาลัสซีเมีย. กรุงเทพมหานคร : โอ เอส พริ้น ติ้ง เฮาส์, 2541 : 1-6.
Wong P, Thanormrat P, Sritipayawan S, Taytiwat P, Jermnim N, Niyomthom S, et al. Prevalence of thalassemia trait from screening program in pregnant women of Phitsanulok. Thai J Hematol Transfus Med 2004; 14: 181-6.
Department of Provincial Administration. Ministry of Interior Thailand. Thailand’s birth rate [homepage on the Internet]. 2007 [cited 2007 Aug 21]. Available from: https://www.dopa.go.th/
World Health Organization. Iron deficiency anaemia: assessment, prevention, and control: A guide for programme managers. Geneva: WHOPress; 2001
Weatherall DJ, Clegg JB. Inherited haemoglobin disorders: an increasing global health problem. Bull World Health Organ. 2001;79:704-712.
Fucharoen S, Winichagoon P. Thalassemia in Southeast Asia: problem and strategy for prevention and control. Southeast Asian J Trop Med Public Health. 1992;23:647-655.
Fucharoen G, Sanchaisuriya K, Sae-ung N, Dangwibul S, Fucharoen S. A simplified screening strategy for thalassaemia and haemoglobin E in rural communities in southeast Asia. Bull World Health Organ 2004; 82: 364-72
Chappie L, Harris A, Phelan L, Bain BJ. Reassessment of a simple chemical method using DCIP for screening for haemoglobin E. J Clin Pathol 2006; 59: 74-6.
Wiwanitkit V, Suwansaksri J, Paritpokee N. Combined one-tube osmotic fragility (OF) test and dichlorophenol-indolphenol (DCIP) test screening for hemoglobin disorders, an experience in 213 Thai pregnant women. Clin Lab 2002; 48: 525-8.
Kannadit P, Chantana P, Kasem R, Kanyarat T, Somchai S. Low cost combination of DCIP and MCV was better than that of DCIP and OF in the screening for hemoglobin E. J Med Assoc Thai 2008; 91 (10)" 1499-504.
