Evaluation of the validity of the pre-marriage Mean Corpuscular Volume value as a predictive test for β-thalassemia carrier status

  • Ali A. Almomani Department of Medical Laboratory Sciences, Al-Ahliyya Amman University, Zip code (19328), Amman, Jordan. Pharmacological and diagnostic research center, Al-Ahliyya Amman University, Zip code (19328), Amman, Jordan.
  • Ala'a S. Shraim Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, 19328, Amman, Jordan. https://orcid.org/0000-0001-7021-8847
  • Ali M. Atoom
  • Jehad F. Alhmoud
DOI: https://doi.org/10.5937/jomb0-37682
Keywords: premarital screening test, β –thalassemia minor, HPLC, HbA2, MCV, RDW, and RBC count

Abstract


Background: The national mandatory premarital screening test is based on MCV > 80fL value for the detection of β-thalassemia to provide acceptance for marriage. The objective of this study is to assess the efficacy of MCV as a screening test for β-thalassemia trait in the present population. Methods: This study was conducted on 418 blood samples collected from adult individuals. The diagnosis of β‐thalassemia carrier was given to those having HbA2 values equal to or above 3.5%. The diagnostic reliability of different RBC indices and formulas in discriminating cases of β-thalassemia trait were evaluated. Finally, a new index called “Momani” was determined based on MCV, RDW and RBC count. Results:  β-thalassemia trait was identified in 10 % of the cases. The measured MCV value was significantly lower in β-thalassemia carrier group compared to non-carrier group (p = <0.001). MCV value and RBC count showed a higher diagnostic reliability than other RBC indices. We found that MCV ≤ 74.45fl is more suitable cut off value of MCV with 86.2% specificity, 71.4% sensitivity, 36.6% positive predictive value, and 96.4% negative predictive value. Finally, our index “Momani” was found to be useful in predicting carrier and paralleled the performance of Sirdah, Mentzer, and Ehsani indices. Conclusion: MCV<80 is a useful but not a perfect cut-off point for the screening of β-thalassemia carriers from non-carriers. The diagnostic accuracy of MCV can be improved by selecting a new cutoff value. Moreover, “Momani” index shows good discrimination ability in diagnosing β -thalassemia carrier in our population.

Author Biography

Ala'a S. Shraim, Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, 19328, Amman, Jordan.

Assistant Professor in Biochemistry 

Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, 19328, Amman, Jordan.

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Published
2022/08/30
Issue
Vol. 42 No. 2 (2023): Journal of Medical Biochemistry
Section
Original paper

Copyright (c) 2022 Ali Almomani, Ala'a Shraim, Ali Atoom, Jehad Alhmoud

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