SCREENING FOR B-THALASSEMIA CARRIER AMONG STUDENTS IN ASECONDARY SCHOOL IN DIARB NEGM,SHARKIA

Abstract

ABSTRACT
Background:Beta-Thalassemia represents a major public health problem in Egypt. The carrier rate varies
between 5.5% to ≥ 9%; it is estimated that there are 1000/1.5 million per year live births born with β-
thalassemia. In spite of optimal treatment being available, only a few patients can afford it. Unfortunately,
most patients suffer from complications of blood transfusions, mainly transfusion transmitted viral infections
and iron overload. Prevention by carrier detection and prenatal diagnosis is needed in populations with high
incidence of the disease, such as Egypt.
Methods:This was a prospective cross-sectional study conducted on 614 secondary school students in Diarb
Negm, Sharkia Governorate. All subjects were subjected to the following: Complete blood count,Serum
ferritin level, Serum iron level, TIBC. Subjects with microcytic anemia were subjected to specific laboratory
tests: HPLC (High Performance Liquid Chromatography) which include hemoglobin A2(HbA2).
Results:Complete blood count testing of the 614 subjects in this study revealed that 55.2 % were normal and
44% were anemic, 5.6% had normocytic anemia and 39.2% had microcytic anemia.Subjects with microcytic
anemia were further subdivided into two groups according to their HbA2 level into; β-Thalassemia carrier
group with high level of HbA2 >3.5% and normal to high (serum iron, serum ferritin) and normal to low
TIBC were 8.5% and Non-carrier group; All with normal levels of HbA2< 3.5%, low serum iron, low serum
ferritin, high TIBC, were 31.6% of subjects and diagnosed as iron deficiency anemia.Carriers rate was 8.5%,
53.8% were males and 46.2% were females.There were increase in mean value of RBCS count, serum iron
and serum ferritin in carriers as compared to non-carriers, and decrease in mean value of HB, HCT, MCV,
MCH, MCHC find TIBC level in carriers as compared to non-carriers. There was a significant positive
correlation between HbA2 and HCT, RBCS count and serum ferritin, while significant negative correlation
between HbA2and MCV.
Conclusion: Carrier rate among 614 secondary school students in Diarb Negm,Sharkia Governorate was
8.5%.Hemoglobin A2 is the gold standard for B-Thalassemia carrier screening.
Key words:Beta-thalassemia; Microcytic hypochromic anemia; Screening; B-Thalassemia Carrier