Comparing prevalence of Iron Deficiency Anemia and Beta Thalassemia Trait in microcytic and non-microcytic blood donors: suggested algorithm for donor screening.
BACKGROUND
The prevalence of microcytosis in donors and Iron Deficiency Anemia (IDA) and Beta-Thalassemia trait (BTT) in microcytic and non-microcytic donors has not been studied in India. The present study aims at finding the same.


METHODS
Initially 925 donor samples were evaluated on cell-counter. Of these, 50 were found to be microcytic. These were subjected to Ferritin and HbA2 determination. Subsequently, an additional 51, age-and-sex matched non-microcytic donor samples were selected to serve as controls. These were subjected to the same tests.


RESULTS
The prevalence of microcytosis was 5.4% (50/925). Among the microcytic donors, 52% were IDA, 36% BTT, 8% both, and 4% none. In case of non-microcytic donors 29.4% were IDA, 3.9% BTT, and 66.7% none.


CONCLUSIONS
The study revealed a high prevalence of IDA and BTT in blood donors and a higher probability of finding these in the microcytic samples. This prompted authors to suggest an algorithm for screening of blood donors for IDA and BTT. The algorithm recommends doing an hemogram on all donor samples, routinely. Ferritin could be done only in microcytic samples. At levels lower than15 ng/ml, it is diagnosed as IDA, and therefore, HPLC is performed only for non-IDA samples with Ferritin levels higher than 15 ng/ml. By employing this algorithm, a substantial number of IDA and BTT could be diagnosed while keeping the number of Ferritin tests small and the number of HPLC tests even smaller and thus making it cost efficient.
Tiwari
Aseem K
AK
Director-Technical, IMA Blood Bank of Uttarakhand.
Chandola
Iva
I
N Engl J Med. 1993 Jul 15;329(3):190-3
8515791
Indian J Med Res. 2006 Dec;124(6):641-6
17287551
Asian J Transfus Sci. 2008 Jan;2(1):9-12
20041071
J Clin Pathol. 1996 Dec;49(12):1021
9038747
Isr J Med Sci. 1978 Nov;14(11):1127-31
750537
Br J Haematol. 1999 Aug;106(2):270-80
10460583
J Gen Intern Med. 1992 Mar-Apr;7(2):145-53
1487761
Am Fam Physician. 2007 Mar 1;75(5):671-8
17375513
Clin Chem. 2000 Aug;46(8 Pt 2):1284-90
10926923
Scand J Clin Lab Invest. 2007;67(1):87-95
17365986
Postgrad Med. 1986 Nov 1;80(6):83-95
3534833
Arch Pathol Lab Med. 2000 Sep;124(9):1320-3
10975930
Med Clin North Am. 1992 May;76(3):549-66
1578956
Arch Pathol Lab Med. 2002 Mar;126(3):336-42
11860310
Sangre (Barc). 1990 Jun;35(3):223-6
2204125
N Engl J Med. 1999 Jul 8;341(2):99-109
10395635
N Engl J Med. 1973 Feb 15;288(7):351-3
4682945
Acta Haematol. 1979;62(4):236-9
119417
N Engl J Med. 1997 May 1;336(18):1298-301
9113933
Nutr Clin Pract. 2008 Apr-May;23(2):128-41
18390780
Clin Chim Acta. 2001 Nov;313(1-2):187-94
11694258