Frequency of Beta thalassemia trait in pediatric age group in a tertiary care hospital in south India

  • B N Krishnamurthy
  • S R Niveditha Kempegowda Institute of Medical sciences
  • Poornima Shankar
Keywords: Beta thalassemia trait, South India, Discriminant functions

Abstract

Background: Approximately 3% of world’s population carry  β-thalassemia genes. The prevention of birth of Beta Thalassemia major children lies in effectively screening the carriers.   Prevalence of β-thalassemia trait (BTT) varies from 3.5% to 14.9% in India. The objective of the present study was to study the frequency of BTT in pediatric age group  at a medical college hospital in Bengaluru and  compare the effectiveness of various  discriminant functions (DFs) in predicting BTT in microcytic cases.Methods: From January-2010 to June-2011, 574 pediatric cases with MCV <80fl were screened for possible BTT with five DFs ie.,  Mentzer index (DF1) , Shine and Lal (DF2) , Srivastava Index (DF3), RDW index  (DF4 ) and Green and King index (DF5).  Cases with ≥ 2  positive DFs were subjected to haemoglobin  electrophoresis on agarose gel at pH 8.6.  Cases with HbA2 levels ≥4.0%, were diagnosed  as   BTT. Result: About 195 cases showed positivity for at least two of the DFs suggesting BTT,  among whom HbA2 level ≥4.0 was seen in  119 cases (frequency  of 19.76%). Cases with BTT, majority (55.63%) showed  normocytic normochromic blood picture with  a mean HbA2  of  5.22± 0.79%,  mean RBC count  of  4.94±0.48 x 1012/l and  mean Haemoglobin of  11.38±1.86 gms/dl. DF2, DF4 and DF5 showed greater  sensitivity (85.84%, 85.85% & 82.3%  respectively).  Conclusion: Frequency of  BTT  was  19.76% among pediatric age group with microcytosis. DF2, DF4 and DF5 along with routine hemogram data in microcytic cases could  effectively discriminate between BTT and non-BTT. Being a community based hospital catering predominantly to vokkaliga community, the high frequency of BTT could reflect the increased prevalence, thereby  creating a need for  awarenesss and   conducting regular  screening programmes to detect BTT. 

Author Biography

S R Niveditha, Kempegowda Institute of Medical sciences
professordepartment of pathology

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Published
2016-04-27
Section
Original Article