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A study of thalassemia screening of 1000 medical students and comparison of various screening methods

Om Vrajlal Bodarya, Hardik Makwana, Nayana Lakum, Atul Shrivastav, Jayesh Joshi, Ashok Agnihotri.

Abstract
Background: ő≤-thalassemias are widespread throughout many countries including India. India has 3.5 crores thalassemic carriers with about 10,000 thalassemic birth every year in India. In Gujarat, there are about 6000 thalassemic children. The prevalence of ő≤-thalassemia trait (BTT) is not uncommon in India and its incidence is rising in certain states including Gujarat.

Objective: (1) To evaluate the prevalence of BTT among medical students above 18 years in C.U. Shah medical college; (2) To compare specificity of NESTROFT (Naked Eye Single Tube Red Cell Osmotic Fragility Test) with Hb-Electrophoresis method for screening of BTT; (3) To compare specificity of Mentzerís index with Hb-Electrophoresis method for screening of BTT; (4) To create awareness among medicos about BTT.

Materials and Methods: Blood (2 mL) was collected from 1000 medical students; complete blood count (CBC), peripheral smear examination, and NESTROFT were done on all samples. HbA2 levels were measured by fully automated cellulose acetate electrophoresis GENIOS-INTERLAB on suspected samples for BTT on basis of CBC, peripheral smear findings, and NESTROFT. HbA2 levels >3.5 were taken as gold standard for diagnosing BTT.

Results: In this study, we found the incidence of BTT being 4.1% (41/1000), that of iron deficiency anemia being 7.3% (73/1000) and that of megaloblastic anemia being 5.4% (54/1000). Three students were found to be sickle cell trait and one to be Hb D. These four cases were confirmed by HPLC at higher center.

Conclusion: Prevalence of BTT is high in India and aggressive control measures should be taken to prevent it. Government and NGOs should concentrate attention to educate MEDICOS and public at large. This will decrease financial burden on families of thalassemia major patients and society at large.

Key words: Medical students, thalassemia, screening methods



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