Journal of Medical Screening > Volume 14, Number 4 > Pp. 169-173

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Original Articles

Is NESTROFT sufficient for mass screening for β-thalassaemia trait?

Manju Mamtani, Kishalaya Das, Anil Jawahirani, Vinky Rughwani and Hemant Kulkarni , Lata Medical Research Foundation, Nagpur, India; Thalassaemia Society of India, Nagpur, India; Thalassaemia Society of India, Nagpur, India; Thalassaemia Society of India, Nagpur, India; Department of Cardiology, Superspeciality Hospital & Postgraduate Institute, Nagpur, India; Thalassaemia Society of India, Nagpur, India; Lata Medical Research Foundation, Nagpur, India

Objectives: Prevention of β-thalassaemia trait will, for the foreseeable future, hinge on effective screening strategies. Routine use of haematological data from automated cell counters may complement the results of the Naked Eye Single Tube Red cell Osmotic Fragility Test (NESTROFT), especially because of the high cost of a false-negative error. Our objective was to assess the potential additive value of routine haematological data in screening for β-thalassaemia trait.

Settings: Community survey of asymptomatic volunteers.

Methods: Using the NESTROFT results, haematological data and haemoglobin A₂ concentration from 1435 young, asymptomatic Sindhi subjects recruited in a population-based survey, and statistical analysis by classification tree approach, we examined whether haematological parameters have discriminatory utility additional to that of NESTROFT in screening for β-thalassaemia trait.

Results: We observed that in the derivation subset from which the classification tree was generated, there was only a marginal – albeit statistically significant – improvement in the screening performance of NESTROFT, whereas there was no such improvement attributable to the use of haematological parameters in a separate validation subset.

Conclusion: Our results further substantiate the claim that the use of NESTROFT is highly indicated for screening for β-thalassaemia trait in regions where the prevalence is high and the resources are constrained.

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