Use of NESTROFT as a screening test for the carriers of thalassemia major
Objective: To evaluate use of NESTROFT as a screening test for the carrier of thalassemia major.
Design: prospective study. Settings and participants: 121 random clinically normal children who were siblings of thalassemia major patients who registered at thalassemia welfare society of J K LON hospital kota. Intervention: All cases were investigated for CBC, NESTROFT and HbA2 estimation by HPLC method.
Result: Total 121 cases were screened for carrier by HPLC method for HbA2 estimation. Total 59 (48.76%) cases had HbA2 level ≥3.5 %, considered as carrier while 62 (51.24%) cases were noncarrier. The Sensitivity, specificity, PPV and NPV of MCV<80, Mentzer index (<13 were positive), and NESTORFT, were 89.83%, 46.77,61.62% ,82.85% ; 83.05%, 97.36%, 96.07% ,88.09 % and 93.22%, 88.70, 88.7 and 93.22 % respectively. So Nestorft is better test (sensitivity-93.22% and NPV is 93.22%) for screening for carrier.
Conclusion: It is concluded that β thalassemia carriers are more prevalent in siblings of thalassemia major. For screening NESTORF test is reliable and cost effective and can be used for mass hemoglobinopathies screening programmes.
2. Sachdev R Dam AR, Tyagi G. Deletion of Hb variant and hemoglobinopathies in Indian population using HPLC Report of 2600 cases. Indian J Pathol microbial. 2010 jan-mar; 53(1) :57-62. [PubMed]
3. Choudhary VP, Desai N, Patil HP, et al: Current management of homozygous beta thalassemia. Indian Pediatr 1991: 28: 1221-1229. [PubMed]
4. Choudhry VP, Desai N, Pati HP, Nanu A. Current management of homozygous beta thalassemia. Indian Pediatr. 1991 Oct;28(10):1221-9. [PubMed]
5. Manglani M, Lokeshwar M. R., Vani V. G., et al: 'NESTROFT'-An effective screening test for beta thalassemia trait. Indian Pediatrics, 1997; 34:702-707. [PubMed]
6. Thomas B, Shrivastava A, Jayasselan L et al: NESTROFT as a screening test for detection of thalassemia in common haematopathies. An evaluation against a high performance liquid chromatographic method. Indian J Med, 1996. [PubMed]
7. Mohanty D, colah RB, Gorakshakar AC, Nandkarni AH, Phanasgonkar SP, Shetty S, et al. Genetic disorder in hematological practice in India. Community genetics 2002; 197-200. [PubMed]
8. BC Mehta et al , A screening of β thalassemia trait, published in Indian journal of medical science year 2002 vol. 56 issue 11 page 537-544.
9. Randolph TR. Thalassemia. In: McKenzie SB, Williams JL, editors. Clinical Laboratory Hematology. 2nd ed. New York: Pearson; 2009. p. 231-56.
10. Klee GG, Fairbabks VF, Pierre RV,O'Sullivan MB. Routine erythrocyte measurements in diagnosis of iron deficiency anemia and thalassemia minor. Am J Clin Pathol 1976; 66: 870-877. [PubMed]
11. Chopra BS, Nair V, Gupta PK, Mishra DK, Sharma A, Mathew OP. Spectrum of Hemoglobinopathies in a Tertiary Care Hospital of Armed Forces. Medical Journal of Armed Forces India 2008;64(4):311-14. [PubMed]
12. Colah R, Surve R, Wadia M, Solanki P, Mayekar P, Thomas M, et al. Carrier Screening for β-Thalassemia during Pregnancy in India: A 7-Year Evaluation. Genet Test. 2008 Jun;12(2):181-5. [PubMed]
13. Sujatha R, Sreekantha, Niveditha S ,Avinash S, Remya,Vinodchandran, Rangaswamy- The study of recent biochemical and pathological aspects of thalassemia International Journal of Research in Health Sciences. Oct–Dec 2013 Volume- 1, Issue-3 p.140-152 . [PubMed]
14. Manglani M, Lokeshwar MR, Vani V.G. , Nishi B and Vijay M, ‘NESTROFT’ – An Effective Screening Test for Beta – Thalassemia Trait. INDIAN PEDIATRICS 1997;(34):702 – 707. [PubMed]
15. Maheshwari. M, Arora S, Kabra M, Menon PSN. Carrier Screening and prenatalDiagnosis of Beta thalassemia. Indian Pediatrics 1999; 36:1119 – 1125. [PubMed]
16. Tyagi S, Dass J, Sharma M. Diagnosis of Thalassemia and Haemoglobinopathies. In: Agarwal MB editor. Haematology Today. Mumbai:Agarwal Publisher;2010. p. 91-101.
17. Thomas S ,Srivastav A, Jeyaseelan L, Dennison D, Chandy M. et al Department of Haematology, Christian Medical College Hospital, Vellore. Studied on NESTROFT as a screening test for the detection of thalassemia & common hemoglobinopathies -- an evaluation against a high performance liquid chromatographic method. In indian j. of med res 1996 aug 104: 194-7. [PubMed]
18. Raghavan K, Lokeshwar MR,Birewar N,Nigam V,Mangalani MV,Raju .Evaluation of naked eye single tube red cell osmotic fragility test in detecting β-thalassemia trait.Indian Pediatr 1991;28:469-472. [PubMed]
Copyright (c) 2016 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.