title: NESTROFT - A Valuable, Cost Effective Screening Test for Beta Thalassemia Trait in North Indian Punjabi Population.
abstract: OBJECTIVE
  Beta-thalassemia continues to be a cause of significant burden to the society, particularly in the poorer developing countries. The objective of the present study was to evaluate the validity of "NESTROFT" (Naked Eye Single Tube Red Cell Osmotic Fragility Test) as a useful screening tool in the diagnosis of beta thalassemia trait.
  
  
  METHODS
  The present study was conducted on 150 subjects in the department of haematology in a tertiary health care center in north Indian state of Punjab. In group I, 111 cases diagnosed as microcytic hypochromic anaemia were selected. In group II, 39 individuals (the family members of known cases of beta thalassemia major) were selected. Complete haemogram, NESTROFT and HbA2 levels by electrophoresis were done and the results were tabulated and analyzed statistically.
  
  
  RESULTS
  Of the 111 cases in group I, 20 (18%) gave positive results with NESTROFT while 91 cases (82%) tested negative. In group II, out of 39 cases, 30 (76.92%) tested positive with NESTROFT while 9 gave a negative result. In group I, out of 20 NESTROFT positive cases, only 3 had HbA2 levels more than 3.5%. In group II, all the 30 NESTROFT positive cases had HbA2 levels more than 3.5%. The test showed a sensitivity of 100%, specificity of 85.47%, a positive predictive value of 66% and a negative predictive value of 100%.
  
  
  CONCLUSIONS
  Thus, NESTROFT is a valuable, cost-effective screening test for beta thalassemia trait and appears to be a valid test in rural setting with financial constraints.
authors.affiliation: Associate Professor, Department of Pathology, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, India .
authors.forename: Sanjay
authors.initials: S
authors.lastname: Piplani
authors.affiliation: Associate Professor, Department of Pathology, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, india .
authors.forename: Rahul
authors.initials: R
authors.lastname: Manan
authors.affiliation: Assistant Professor, Department of Anatomy, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, India .
authors.forename: Monika
authors.initials: M
authors.lastname: Lalit
authors.affiliation: Professor, Department of Pathology, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, India .
authors.forename: Mridu
authors.initials: M
authors.lastname: Manjari
authors.affiliation: Professor, Department of Pathology, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, India .
authors.forename: Tajinder
authors.initials: T
authors.lastname: Bhasin
authors.affiliation: Junior Resident, Department of Pathology, Sri Guru Ram Das Medical College (SGRDIMSR) , Amritsar, India .
authors.forename: Jasmine
authors.initials: J
authors.lastname: Bawa
keywords: Beta Thalassemia; HbA2; NESTROFT; Punjab