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Is NESTROFT sufficient for mass screening for beta-thalassaemia trait?
Manju Mamtani1, Kishalaya Das, Anil Jawahirani
1Lata Medical Research Foundation, Nagpur, India.
Journal of Medical Screening
|December 15, 2007
Summary
Routine haematological data offers minimal added value to the Naked Eye Single Tube Red cell Osmotic Fragility Test (NESTROFT) for beta-thalassaemia trait screening. NESTROFT remains a highly recommended, cost-effective screening method in high-prevalence regions.
Area of Science:
- Hematology
- Genetic screening
- Public health
Background:
- Beta-thalassaemia trait prevention relies on effective screening strategies.
- Automated cell counter data may complement existing tests like NESTROFT.
- Minimizing false-negative errors in screening is crucial due to high costs.
Purpose of the Study:
- To evaluate the additional value of routine haematological data in beta-thalassaemia trait screening.
- To determine if haematological parameters improve upon NESTROFT performance.
- To assess the discriminatory utility of haematological parameters beyond NESTROFT.
Main Methods:
- A population-based survey of 1435 asymptomatic Sindhi subjects.
- Utilized NESTROFT results, haematological data, and haemoglobin A(2) concentration.
- Employed a classification tree approach for statistical analysis.
Main Results:
- A marginal, statistically significant improvement in NESTROFT screening performance was observed in the derivation subset.
- No significant improvement in screening performance was found using haematological parameters in a separate validation subset.
- The additive value of routine haematological data was minimal.
Conclusions:
- NESTROFT is highly indicated for beta-thalassaemia trait screening in resource-constrained, high-prevalence areas.
- Routine haematological data does not significantly enhance NESTROFT's screening efficacy.
- NESTROFT remains a primary tool for beta-thalassaemia trait screening.