Use of NESTROFT as a screening test for the carriers of thalassemia major

Abstract

Objective: To evaluate the utility of NESTROFT as a screening test for carriers of thalassemia major. Design: prospective study. Settings and participants: Total 121 clinically normal siblings, of thalassemia major patients who are registered at thalassemia welfare society of J K LON hospital Kota, were selected randomly for study. Intervention: All cases were investigated for CBC, Mentzer's index, NESTROFT and HbA2 estimation by HPLC method. Result: Total 121 cases were screened for thalassemia carrier by HbA2 estimation using HPLC technique. Out of which total 59 (48.76%) cases showed HbA2 level ≥3.5%considered as carrier while rest 62 (51.24%) cases were having normal Hemoglobin pattern. The Sensitivity, specificity, positive predictive value and negative predictive value of MCV<80 are 89.83%, 46.77%, 61.62% and 82.85% respectively. The Sensitivity, specificity, positive predictive value and negative predictive value of Mentzer's index are 83.05%, 97.36%, 96.07% and 88.09 % respectively. The Sensitivity, specificity, positive predictive value and negative predictive value of NESTROF test are 93.22%, 88.70%, 88.7% and 93.22 % respectively. So NESTROFT is better test (sensitivity is 93.22% and negative predictive value is 93.22%) for screening for Thalassemia carrier. Conclusion: NESTROF test is reliable, cost effective and better screening test for Thalassemia carrier detection. Positive cases can be confirmed by HPLC. NESTROFT can be used in mass hemoglobinopathies screening programmes.

Assessing NESTROFT as a preliminary screening tool for thalassemia in the Malayali tribes of Dharmapuri district, Tamil Nadu, India

“…For field research and mass screening, NESTROFT has proven to be an effective, efficient, quick, and reasonably priced tool. [ 15 ]…”

“…A study done in tertiary care hospitals showed 100% sensitivity, 100% specificity, 100% PPV, and 100% NPV. [ 15 ] The results have the highest values because the study is hospital-based. A study done in the year 2021 showed similar results: a sensitivity of 84.2%, a specificity of 96.2%, a PPV of 69.5%, and an NPV of 98.3%.…”