Is NESTROFT better than the hematological indices for screening of beta-thalassemia trait: an answer in rural scenario

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Original Article

Author Details : Sanjay Piplani, Manjot Kaur, Manas Madan, Monika Lalit

Volume : 4, Issue : 1, Year : 2017

Article Page : 63-70

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Abstract

Introduction: Clinical and pathological distinction between beta thalassemia trait (????-TT) and iron deficiency anemia (IDA) is of paramount importance. On day to day basis, these two are differentiated by many hematological indices which are derived by mathematical calculations. In this scenario, naked eye single tube red cell osmotic fragility test (NESTROFT) has been slightly relegated. The aim of the present study was to compare by statistical means the standings of these indicators with NESTROFT and also measure efficiency of both by Youden’s index.
Material & Methods: The study was conducted on 225 patients diagnosed with mild microcytic hypochromic anemia on complete blood count and PBF. 12 discrimination indices were calculated with simultaneous NESTROFT and HbA2 levels estimation. The results were compiled and analyzed by statistical means.
Results: The Shine & Lal and Ricerca et al indices exhibited the highest sensitivity of 100% each while The England & Fraser index demonstrated the highest specificity of 90.2%.
The highest PPV was found for Mentzer index(77.3%).
The highest NPV was found for Ricerca et al & Shine & Lal indices of 100% each.
The highest Youden’s index was shown by Mentzer index(81.3%).
NESTROFT showed a sensitivity, specificity, PPV and NPV of 98.6%, 83.7%, 74.0%, 99.2% respectively. The Youden’s index for NESTROFT was 82.3%.
Conclusion: NESTROFT proved to be a better test than all other hematological indices for detection of ????-TT. It scores due to its good statistical end results including good efficiency indicator. Additionally, it is observed that it is a test with good cost benefit ratio, easy performability and does not require tedious and hi-tech equipment. Hence NESTROFT should be the primary screening tool for beta thalassemia trait.

Keywords: Iron deficiency anemia(IDA), Beta thalassemia trait (????-TT), NESTROFT, Discrimination Indices, HBA2

 

How to cite : Piplani S, Kaur M, Madan M, Lalit M, Is NESTROFT better than the hematological indices for screening of beta-thalassemia trait: an answer in rural scenario. Indian J Pathol Oncol 2017;4(1):63-70

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