Red Cell Indices and Formulas Used in Differentiation of β-Thalassemia Trait from Iron Deficiency in Thai School Children

Abstract

Red cell indices and formulas have been established as simple, fast, and inexpensive means for discrimination between the β-thalassemia (β-thal) trait and iron deficiency. However, there were no reports of the diagnostic reliability of different red cell indices and formulas in discrimination of β-thal trait from iron deficiency in the Thai population. The aim of this study was to examine the diagnostic accuracy of five red cell indices [red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH), mean corpuscular Hb concentration (MCHC), and red cell distribution width (RDW)] and eight formulas (Sirdah, Green & King, RDW Index, Menzler, England & Fraser, Ehsani, Srivastava, and Shine & Lal). Their sensitivity, specificity, positive and negative prognostic value and efficiency, were analyzed in 77 Thai school children, 21 with the β-thal trait and 56 with iron deficiency. The Sirdah and Srivastava formulas proved to be the most reliable indexes as they had 100.0% sensitivity and negative predictive value, the highest efficiency (97.4%), and the highest Youden’s Index value (96.4%). Therefore, these formulas could be used in initial discrimination of the β-thal trait from iron deficiency in Thai school children.

• β-Thalassemia (β-thal)
• formulas
• iron deficiency
• red cell indices
• Thai school children

Acknowledgements

The authors thank technicians at the Associated Medical Sciences Clinical Service Center, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand for their help and assistance. The authors are grateful to Roscoe C. Butler, Jr. (Kad Farang Village, Chiang Mai, Thailand) for editing the manuscript.