Asian Journal of Transfusion Science
Home About Journal Editorial Board Search Current Issue Ahead of print Back Issues Instructions Subscribe Login  Users: 567 Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 172-178

Mean corpuscular volume/mean corpuscular hemoglobin values are not reliable predictors of the β-thalassemia carrier status among healthy diverse populations of Himachal Pradesh, India

1 State Institute of Health and Family Welfare, Shimla, Himachal Pradesh, India
2 National Health Mission (NHM), Government of Himachal Pradesh, Shimla, Himachal Pradesh, India
3 Prof. and Head Biotechnology, Bennett University, Greater Noida, Delhi, India
4 Department of Centre for Advance Research (CFAR), King George's Medical University, Lucknow, Uttar Pradesh, India
5 Independent Researcher and Master's from CSK Himachal Pradesh Agriculture University, Palampur, Himachal Pradesh, India

Correspondence Address:
Dr. Omesh Kumar Bharti
State Epidemiologist, SIHFW and Principal Investigator Thalassemia Project NHM, Himachal Pradesh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.AJTS_109_18

Rights and Permissions

Background: Himachal Pradesh is a hill state in North India in the Western Himalayas. β-thalassemia is a genetic disorder of hemoglobin inherited in an autosomal recessive manner that results in defective globin production leading to the early destruction of red blood cells. β-thalassemia has long been neglected in Himachal Pradesh due to popular belief that it runs along “Lahore-Gujarat-Punjab” belt in India. Therefore, there is no β-thalassemia testing facility currently in the state. Methods: To estimate the prevalence of β-thalassemia carriers, we calculated the sample size based on probability proportional to size self-weighing design. In each of 20 selected colleges, 111 students having an age of 18–25 were tested for high-performance liquid chromatography (HPLC) and complete blood count. Some were further tested for the mutations. We computed sensitivity, specificity, positive predictive value (PPV) and negative predictive value, and receiver operating characteristic curve for mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) red cell parameters. Results: Of the 2220 students, 57 were found to be β-thalassemia carrier by HPLC. The overall prevalence rate was 2.6% which translates to probable 180,000 β-thalassemia carriers in Himachal Pradesh. Six districts bordering highly endemic Punjab had a higher prevalence. Hemoglobin D-Punjab, Heterozygous-Iran Trait, and raised fetal hemoglobin were found. Thalassemia major and sickle cell disease were not found. Anemic status or MCV/MCH parameters were not found to be reliable predictors of thalassemia carrier status among the healthy populations of HP. The predominant mutation found was IVS 1–5 G > C. Conclusion: Popular ongoing strategy for screening with MCV and MCH has low-PPV and can miss upto 37% of true thalassemia carriers. HPLC is better strategy for screening carriers and reduces further spread of thalassemia.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded115    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


Association Contact us | Sitemap | Advertise | What's New | Copyright and Disclaimer | Privacy Notice

2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006