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Patra index and Mentzer index - A retrospective comparative study to differentiate Beta-Thalassemia Trait from iron

Satyabrata Patra1, Abhirup Shome1, Camellia C Patra2

  • 1Department of Pathology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Journal of Family Medicine and Primary Care
|December 17, 2025
PubMed

Insights

The Patra index is a highly accurate and cost-effective tool for differentiating beta-thalassemia trait (BTT) from iron deficiency anemia (IDA) in microcytic hypochromic anemia cases. This index offers superior diagnostic performance compared to the Mentzer index, aiding primary care physicians.

Area of Science:

  • Hematology
  • Clinical Diagnostics
  • Medical Biochemistry

Background:

  • Beta-thalassemia trait (BTT) and iron deficiency anemia (IDA) are leading causes of microcytic hypochromic anemia.
  • Accurate differentiation is critical for appropriate management and reducing public health burdens, especially in pediatric populations.
  • Red blood cell (RBC) indices offer a simple, rapid, and cost-effective diagnostic approach.

Purpose of the Study:

  • To evaluate the diagnostic performance of the Mentzer index and the Patra index in differentiating BTT from IDA.
  • To compare the efficacy of these indices in patients with microcytic hypochromic anemia.

Main Methods:

  • A cross-sectional observational study involving 406 patients with microcytic hypochromic anemia (aged 3-50 years).
  • Evaluation of the Mentzer index (MCV/RBC) and Patra index (MCV/RDW) using sensitivity, specificity, PPV, NPV, efficiency, and Youden's index.
  • Data collected from the Department of Pathology, Rajendra Institute of Medical Sciences (RIMS), Ranchi.

Main Results:

  • The Patra index demonstrated superior diagnostic accuracy with 88.23% sensitivity and 99.7% specificity.
  • The Youden's index for the Patra index was 87.93%, indicating its reliability in distinguishing BTT from IDA.
  • The Patra index proved more effective than the Mentzer index for differentiating these conditions.

Conclusions:

  • The Patra index is a highly sensitive, specific, and affordable screening tool for primary care, especially in resource-limited settings.
  • Its ease of use and low cost make it ideal for initial screening of microcytic anemia.
  • Positive cases identified by the Patra index can be confirmed using HPLC on the same blood sample.
Abstract

Keywords:
BTTIDAMCVMENTZER indexPATRA indexRDWsensitivityspecificity

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