Is NESTROFT sufficient for mass screening for beta-thalassaemia trait?
OBJECTIVE
Prevention of beta-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 beta-thalassaemia trait.


METHODS
Community survey of asymptomatic volunteers.


METHODS
Using the NESTROFT results, haematological data and haemoglobin A(2) 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 beta-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.


CONCLUSIONS
Our results further substantiate the claim that the use of NESTROFT is highly indicated for screening for beta-thalassaemia trait in regions where the prevalence is high and the resources are constrained.
Mamtani
Manju
M
Lata Medical Research Foundation, Nagpur, India.
Das
Kishalaya
K
Jawahirani
Anil
A
Rughwani
Vinky
V
Kulkarni
Hemant
H
D000328:Adult; D003663:Decision Trees; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012680:Sensitivity and Specificity; D017086:beta-Thalassemia / Q000145:classification / Q000175:diagnosis* / Q000235:genetics