Reliability of Different RBC Indices and Formulas in the Discrimination of ?-Thalassemia Minor and Iron Deficiency Anemia in Surabaya, Indonesia

Abstract

In this study, we evaluated the RBC indices in differentiating β-thalassemia minor and iron deficiency anemia in a healthcare center. This was an observational analytic study with a cross-sectional design using blood specimens of children aged 3 years to 17 years with microcytic hypochromic anemia based on the results of complete blood counts and evaluation of peripheral blood smears. Calculation of the RBC indices was performed as an initial screening to differentiate β-thalassemia minor and iron deficiency anemia. Iron profile examination and hemoglobin electrophoresis were performed to confirm the diagnosis of β-thalassemia minor and iron deficiency anemia. The results of the independent samples t-test showed significant differences in Hb, MCV, MCH, and MCHC between β-thalassemia minor and iron deficiency anemia (p <0.05). The results of the Mann Whitney test showed a significant difference in the Mentzer Index to distinguish between β-thalassemia minor and iron deficiency anemia (p <0.05). Also, the results of the independent samples t-test showed significant differences in the Green & King formula, Sirdah et al. formula, and the Maltos and Carvalho Index (p <0.05). The Green and King formula has a diagnostic sensitivity of 78.6% and a specificity of 76.6% and an accuracy of 78.03%. Various formulas based on the results of complete blood count parameters have been developed to detect β-thalassemia minor in areas with a high prevalence of β-thalassemia with different sensitivity and specificity. In this study, it showed that the Green and King formula has a diagnostic sensitivity of 78.6% and a specificity of 76.6%, and an accuracy of 78.03%. Green and King's formula can be applied as an initial screening to differentiate β-thalassemia minor and iron deficiency anemia