A Different Look at Premarital Hemoglobinopathy Screening in Primary Care

Abstract

Objective: Despite the high prevalence of hemoglobinopathies (HBP), the most common single-gene disorders in Turkey, data in some regions are lacking. We aimed to evaluate the effectiveness of the hemoglobinopathy premarital screening program (PMS) and to investigate the contribution of efficient use of complete blood count (CBC) parameters on cost-effectivity. Methods: HMP diagnosed 49171 subjects in 4 years and CBC of subjects with HMP in a year were evaluated retrospectively. Results: The total incidence rate of HBP was 3.41%, β-thalassemia trait (β-TT) was 1.98%, HMP incidence in the PMS group was 2.43%, β-TT was 1.08%. Moreover, HbF, HbD, HbC, HbS, HbE and HbJ were detected with the incidences of 0.49%, 0.14%, 0.05%, 0.04%, 0.007% and 0.009%, respectively. RDW/MCH ratio compared to other indices was the most successful for both sexes in diagnostic efficiency of HBP (AUC: male:0.922female:0.961) and β-TT (AUC: male;0.928 -female:0.961). Conclusions: PMS was found to be an effective application program in HMP screening. RDW/MCH ratio was the most useful and easy parameter in detecting HBP and β-TT in PMS and in terms of reducing unnecessary test requests and cost-effectiveness in public health screenings.