title: Comparative analysis of cellulose acetate hemoglobin electrophoresis and high performance liquid chromatography for quantitative determination of hemoglobin A2.
abstract: BACKGROUND
  The present study is designed to evaluate the reliability and cost effectiveness of cellulose acetate Hb electrophoresis and high performance liquid chromatography (HPLC) in the determination of HbA2 levels.
  
  
  METHODS
  The test population comprised 160 individuals divided into four groups: normal individuals, β-thalassemia trait (BTT) patients, iron deficiency anemia (IDA) patients, and co-morbid patients (BTT with IDA). HbA2 levels determined using cellulose acetate Hb electrophoresis and HPLC were compared.
  
  
  RESULTS
  HbA2 levels were found to be diagnostic for classical BTT using either method. In co-morbid cases, both techniques failed to diagnose all cases of BTT. The sensitivity, specificity, and Youden's index for detection of the co-morbid condition was 69% and 66% for HPLC and cellulose acetate Hb electrophoresis, respectively.
  
  
  CONCLUSIONS
  This study revealed that semi-automated cellulose acetate Hb electrophoresis is more suitable for use in β-thalassemia prevention programs in low-income countries like Pakistan. This technique is easily available, simple and cost effective.
authors.affiliation: Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan. ; Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Shafi Mohammad
authors.initials: SM
authors.lastname: Khosa
authors.affiliation: Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan. ; Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Usman
authors.affiliation: Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Moinuddin
authors.initials: M
authors.lastname: Moinuddin
authors.affiliation: Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Hassan Osman
authors.initials: HO
authors.lastname: Mehmood
authors.affiliation: Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Khansa
authors.initials: K
authors.lastname: Qamar
keywords: Cellulose acetate hemoglobin electrophoresis; Hemoglobin A2; High performance liquid chromatography
references.citation: Scand J Clin Lab Invest. 1999 Feb;59(1):65-70
references.pmid: 10206099
references.citation: J Clin Invest. 1957 Nov;36(11):1615-25
references.pmid: 13475502
references.citation: J Coll Physicians Surg Pak. 2007 Mar;17(3):144-7
references.pmid: 17374299
references.citation: J Clin Pathol. 2009 Jan;62(1):13-7
references.pmid: 19103851
references.citation: Am J Clin Pathol. 2009 Mar;131(3):357-62
references.pmid: 19233839
references.citation: Orphanet J Rare Dis. 2010 May 21;5:11
references.pmid: 20492708
references.citation: Korean J Hematol. 2011 Mar;46(1):41-4
references.pmid: 21461303
references.citation: Int J Lab Hematol. 2012 Feb;34(1):1-13
references.pmid: 21974826
references.citation: Med J Malaysia. 2011 Dec;66(5):429-34
references.pmid: 22390095
references.citation: Biochim Biophys Acta. 2012 Sep;1823(9):1604-16
references.pmid: 22554985
references.citation: Cold Spring Harb Perspect Med. 2013 Mar 01;3(3):a011858
references.pmid: 23388674
references.citation: J Ayub Med Coll Abbottabad. 2011 Apr-Jun;23(2):8-11
references.pmid: 24800331
references.citation: Turk J Haematol. 2009 Dec 5;26(4):167-70
references.pmid: 27265627
references.citation: Br Med J (Clin Res Ed). 1986 Jun 7;292(6534):1505-8
references.pmid: 3087497
references.citation: Br J Haematol. 1996 Sep;94(3):476-82
references.pmid: 8790145