Value of Cell Counter-Based Parameters and Formulas in Detection of β-Thalassemia Minor, the experience of a single Haematological Centre in Iraq

Safa A. Faraj , Haider Nadim Abd Al Jabar , Laith S. Mahdi


Background: Various indices derived from red blood cell (RBC) parameters have been described for distinguishing beta thalassemia minor and other types of hypochromic microcytic anemia. Objective: The study is aimed at investigating the diagnostic reliability of different RBC indices and formulas in differentiation between beta thalassemia minor and other types of hypochromic microcytic anemia. Subjects and Methods: This is a crosssectional study which was carried out since first of Jan 2011 to end of December 2011 on 171 children with hypochromic microcytic anemia in Kut Oncology Centre, Wasit, Iraq. Results: There was a statistical significant difference between thalassemic group and other groups regarding blood indices as well as the eight formulas which were used. The highest correctly identified patients (PCIP) was reported for RBCs count (84%) with sensitivity and specificity of 96.3%. The Youden's index for RBCs was 58.2 which is the highest value compared with other seven parameters or indices which were used in this study. The second highest Youden's index was for G & K index, with 78.4% PCIP, and sensitivity and specificity of 98.2%. Youden's index of red cell distribution width (RDW) was the lowest value compared to other values used in this study as well as the lowest percentage of correctly identified patients (65%). The sensitivity and specificity of RDW for BTM was 86.1%. Conclusion: According to this study, cell counter-based parameters and formulas, particularly RBCs, and Green and King index are superior to all other methods examined for distinguishing between thalassemia trait and other hypochromic microcytic anemia; while, RDW was inadequate and ineffective for that purpose.