Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia

Prommetta, Simaporn; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Yamsri, Supawadee; Chaiboonroeng, Attawut; Fucharoen, Supan

doi:10.11613/bm.2017.040

Cited by 3 publications

(8 citation statements)

References 16 publications

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“…For this purpose, each laboratory requires the appropriate performance of internal and external quality control and participation in the PT program. We have reported the results of the PT programs for initial screening and Hb analysis in Thailand 7,8,17 …”

Section: Discussionmentioning

confidence: 99%

“…No PT program for DNA analysis of hemoglobinopathies has been established in Thailand. Due to the lack of appropriate PT items, most of these PT programs have been operated separately 7–9 . Routine analysis of thalassemia is performed on a single patient blood specimen for all investigation steps, including initial screening, Hb analysis, and DNA analysis.…”

Section: Discussionmentioning

confidence: 99%

“…This is especially difficult for hemoglobinopathies diagnosis since laboratory testing includes initial screening, Hb type analysis, and DNA analysis. Therefore, the PT programs have been established separately for initial screening and Hb analysis using different PT items 7–9 . In contrast, the PT program for DNA analysis of hemoglobinopathies has been rarely described.…”

Section: Introductionmentioning

confidence: 99%

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Generation of a single‐tube quality control material for hemoglobin and DNA analyses of hemoglobinopathies

Pansuwan

Changtrakul

Chaibunruang

et al. 2021

Int J Lab Hematology

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Introduction:Hemoglobinopathies are major public health problems worldwide.Accurate laboratory diagnosis of the carrier is essential, which includes initial screening, Hb analysis, and DNA analysis. For the first time, we have developed a single-tube quality control (QC) sample for these laboratory tests. Methods:The QC sample was made from a lyophilized mixture of the stabilized hemolysate with carbon monoxide saturation and the white blood cells of known thalassemia mutations. Homogeneity and stability were examined by Hb and DNA analyses on day 0 and every month for 12 months, at room temperature, 4°C, and −20°C. A preliminary proficiency testing (PT) program for hemoglobinopathies using this single QC material was developed.Results: Hemoglobin (Hb) and DNA analyses of a single-tube QC sample demonstrated satisfactory results of Hb analysis for at least five months and DNA analysis for at least one year of storage at −20°C. The results obtained from a preliminary PT program on five expert laboratories confirmed that a single tube QC sample prepared could be used as a PT item with various Hb and DNA analyses methods. Conclusion:A single lyophilized control sample has been generated for use in hemoglobinopathies' internal and external quality control program. Unlike other available control materials, which are used for individual testing, a single-tube QC sample generated can be used to control the pre-analytical and analytical processes of both Hb and DNA analyses and is suitable for use in the PT program of hemoglobinopathies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Generation of a single‐tube quality control material for hemoglobin and DNA analyses of hemoglobinopathies

Pansuwan

Changtrakul

Chaibunruang

et al. 2021

Int J Lab Hematology

Self Cite

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“…Regardless of the screening methods used, there is a pressing need to establish external quality assessment (EQA) programmes to monitor how well the tests are performed and interpreted by local staff, to ensure the accuracy and success of all haemoglobinopathy screening programmes. Indeed, an EQA programme implemented in Thailand has been shown to improve the performance of many screening laboratories (Prommetta et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

A “One-Stop” Screening Protocol for Haemoglobinopathy Traits and Iron Deficiency in Sri Lanka

Allen

Perera

et al. 2019

Front. Mol. Biosci.

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Introduction: The high frequencies of carriers of severe haemoglobinopathies and of iron deficiency in Southeast Asia require reliable and affordable tests to improve on current screening procedures. Objectives: We evaluate a “one stop” approach using the THALCON dichlorophenolindophenol (DCIP) and one-tube osmotic fragility (OF) tests and measurement of Zinc Protoporphyrin (ZPP) to detect and distinguish HbE and β-thalassaemia traits from iron deficiency. We compare findings with current screening practice in Sri Lanka that relies on the identification of low mean red cell volume and/or mean red cell hemoglobin for this purpose. Methods: Between November 2017 and May 2018, we undertook a cross-sectional survey of secondary school students in Gampaha district, Sri Lanka. The THALCON–DCIP and OF tests were compared to capillary electrophoresis (CE), used as a gold standard to detect haemoglobinopathies. ZPP was measured in whole blood. Plasma ferritin and C-reactive protein (CRP) were measured in students with a raised ZPP concentration. Results: We collected venous blood samples from 1,324/1,332 (99.4%) students. The median age of the students was 17 (IQR 16–18) years, all were Sinhalese and 814/1,324 (61.5%) were female. CE identified 3 students with HbE trait and 26 students with β-thalassaemia trait. The THALCON–DCIP test was positive only in the 3 students with HbE (sensitivity 100%, 95% CI 29.2–100.0; specificity 100%, 95% CI 99.7–100.0). The THALCON–OF test identified all 26 students with β-thalassaemia trait (sensitivity = 100%, 95% CI 86.8–100.0) and 287 students with a normal CE result (specificity = 77.9%; 95% CI 75.5–80.1). It was also positive in 2/3 (66.7%) students with HbE trait. Iron deficiency (ZPP > 70 μmol/mol heme) was present in 118/1,240 (9.5%) students with a normal hemoglobin genotype, all of whom had plasma ferritin <15 ng/ml and CRP <5 mg/L. Conclusion: This one–stop approach offers reliable and affordable population screening for both haemoglobinopathy traits and iron deficiency in resource-limited settings where these conditions are common and ensures that iron supplements are targeted only to those who require them. Further work is warranted to refine the OF test to reduce the number of false positive results.

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“…This practice may be different in each country. Preliminary proficiency testing (PT) programs for initial screening and Hb analysis have been initiated years ago 8,9 . The PT scheme for Hb variant analysis has been operated to evaluate the proficiency of laboratory participants on accuracy of Hb variant analysis, skills in interpretation of such Hb variant analysis results, and a genetic risk assessment of a couple for having an affected fetus with one of the three severe thalassemia diseases.…”

Section: Introductionmentioning

confidence: 99%

Results from 8 years of the proficiency testing program for diagnosis of hemoglobinopathies under the prevention and control program of thalassemia in Thailand

Pansuwan

Yamsri

Changtrakul

et al. 2021

Int J Lab Hematology

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Introduction Hemoglobin (Hb) analysis is a key testing for diagnosis of hemoglobinopathies. Accurate analysis, interpretation of results, and genetic risk assessment are important. We report on 8 years of the proficiency testing (PT) program for hemoglobinopathies in Thailand. Methods Laboratory participants were required to test two simulated PT items in each cycle using capillary electrophoresis, one was a husband and another was his pregnant wife. Related hematological parameters were provided. The participants also provide interpretation and evaluate the risk of having three severe thalassemia diseases in an expected fetus. Three cycles were operated per year in accordance with the ISO17043 and ISO13528 guidelines. A total of 84 laboratories throughout Thailand were participated. Results A total of 24 PT cycles were performed during 2012‐2019. Most participants had Excellent performance for the PT items with normal, β‐thalassemia trait, hemoglobin E trait, hemoglobin E trait with α‐thalassemia, and Hb H disease. However, when the PT items with homozygous Hb E and Hb E‐β‐thalassemia were tested, an increase in a Needs improvement performance was noted. From 24 PT cycles, the performance with Excellent, Good, Fair, and Needs improvement was ranging from 10.5%‐95.8%, 0%‐11.3%, 0%‐77.2%, and 2.3%‐37.0%, respectively. Conclusion Most participants have proven their performance to be reliable and demonstrated their abilities to provide interpretation and genetic risk assessment on most of the PT items. For complex thalassemia however, a need to improve the interpretation and risk assessment skills is required which is essential for effective prevention and control of severe thalassemia diseases in Thailand.

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Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia

Cited by 3 publications

References 16 publications

Generation of a single‐tube quality control material for hemoglobin and DNA analyses of hemoglobinopathies

Generation of a single‐tube quality control material for hemoglobin and DNA analyses of hemoglobinopathies

A “One-Stop” Screening Protocol for Haemoglobinopathy Traits and Iron Deficiency in Sri Lanka

Results from 8 years of the proficiency testing program for diagnosis of hemoglobinopathies under the prevention and control program of thalassemia in Thailand

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