DIFFERENTIAL DIAGNOSIS OF IRON DEFICIENCY ANEMIA AND BETA THALASSEMIA IN PORT HARCOURT PREGNANT WOMEN USING THE MENTZER INDEX

  • Ransom Jacob Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria
  • Princess Aboko Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria
  • Evelyn Eze Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria
  • Zaccheaus Jeremiah Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria
Keywords: Mentzer Index, Iron deficiency Anaemia, Beta-thalassaemia, Pregnant Women

Abstract


Introduction: The Mentzer index is a cost-effective and accurate method for differentiating between iron deficiency anemia (IDA) and beta-thal[1]assemia. Anemia in pregnancy is a global health concern, especially in developing countries like Nigeria, where it is primarily linked to iron deficiency and may also include other underlying hemoglobin disorders, with beta-thalassemia (βT) being the most common. This cross-sectional study aimed to differentiate between iron deficiency anemia and beta-thalassemia in pregnant women attending tertiary hospitals in Port Harcourt, Nigeria, based on the Mentzer Index.

Materials and Methods: A total of 120 apparently healthy pregnant women aged between 20 and 50 years were recruited for the study. Five milliliters (5 ml) of venous blood were collected from each participant using a disposable syringe and placed into an ethylene diamine tetraacetic acid (EDTA) anticoagulated bottle for full blood count determination using a Mindray automated analyzer. The Mentzer Index was calculated from the mean cell volume (MCV) and red blood cell (RBC) count values. The data obtained were analyzed statistically using Statistical Package for Social Sciences (SPSS) Version 23.

Results: Mean age ± SD of the study population (28.68 ± 5.6 years), Mean + SD of Hb (11.38 + 2.08g/ dl), PCV (31.72 + 4.59%), RBC count (4.65 ± 1.86 x 1012/L), MCV (79.92 ± 5.91 fl) and Platelets count (272.9 ± 42.10 x 109 /L) respectively. Out of 120 participants, 48 (40%) had Hb and PCV values above 11.0 g/dl and 33% respectively. A total of 5 (4.17%) had a Mentzer index < 13 and confirmed beta-thalassaemia, while 67 (55.83%) had a Mentzer index > 13 and confirmed iron-deficiency anaemia indicating a 60% prevalance of anaemia in study population with iron-deficiency anaemia been more common amongst the study population than beta-thalassaemia.

Conclusion: Based on the Mentzer Index calculation, this study revealed a high prevalence of iron deficiency anemia (IDA) and a lower prevalence of beta-thalassemia among pregnant women attending tertiary hospitals in Port Harcourt, Nigeria. Healthcare practitioners should consider incorporating the Mentzer Index as a cost-effective means of differentiating iron deficiency anemia from beta-thalassemia in pregnant women, particularly in rural areas. Additionally, increased awareness and educational programs focusing on proper nutrition and iron supplementation during pregnancy should be advocated.

Author Biographies

Princess Aboko, Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria

Student Researcher Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Rivers State University, Port Harcourt, Nigeria

Evelyn Eze, Rivers State University, Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Port Harcourt, Nigeria

Dr Evelyn Mgbeoma Eze.

ORCID ID: 0000-0001-5129-9063

Associate Professor; Faculty of Medical Laboratory Science, Department of Haematology and Blood Transfusion Science, Rivers State University, Port Harcourt, Nigeria

References

WHO. Anaemia. World Health Organization. 2023. Accessed: 3 December 2023. Available from: https://www.who.int/news-room/factsheets/detail/anaemia#:~:text=Globally%2C%20it%20is%20estimated%20that,due%20to%20disability%20in%202019

Ugwu NI, Uneke, CJ. Iron Deficiency Anemia in Pregnancy in Nigeria—A Systematic Review. Niger J Clin Pract. 2020; 23(7): 889-96. doi: 10.4103/njcp.njcp_197_19.

Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus. 2012; 28(3): 144-6. doi: 10.1016/s0025- 7125(16)30344-3.

De R, Prakash KU, Edison ES. complex interactions in regulation of haematopoiesis-an unexplored iron mine. Genes (Basel). 2021;12(8):1270. doi: 10.3390/genes12081270.

Babah OA, Akinajo OR, Beňová L, Hanson C, Abioye AI, Adaramoye VO, et al. Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study. BMC Pregnancy Childbirth. 2024;24(1):39. doi: 10.1186/s12884-023-06169-1.

Apollos V, Jacob R, Jeremiah Z. Performance evaluation of Veri-Q Red Haemoglobin Meter for point-of-care haemoglobin and packed cell volume estimations. Sanamed. 2024; 19(1): 33–8. doi: 10.5937/sanamed19-48722.

Jacob RB, Boms C, Chukwuigwe-Igbere OE, Nwika GN. Frequency of Rh-e Antigen and reference ranges of Erythrocyte Sedimentation Rate and Red Cell Indices in an Undergraduate Students’ population in Port Harcourt, Nigeria. Afr J Lab Haem Transf Science. 2023; 2(3): 214 - 21. doi:10.59708/ajlhts.v2i3.2327.

Jacob RB, Mba CO,Iduh PB. Haematological Alterations among Cement Loaders in Port Harcourt, Nigeria. Asian Journal of Medicine and Health. 2020; 18(7): 1-8. doi: 10.9734/AJMAH/2020/v18i730218.

National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. Available from: https://dhsprogram.com/pubs/pdf/FR359/FR359.pdf.

Needs T, Gonzalez-Mosquera LF, Lynch DT. Beta Thalassemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531481/

Cao A, Galanello R. Beta-thalassemia. Genet Med. 2010;12(2):61-76. doi: 10.1097/GIM.0b013e3181cd68ed.

Origa R. β-Thalassemia. Genet Med. 2017;19(6):609-19. doi: 10.1038/gim.2016.173.

Osungbade KO, Oladunjoye AO. Preventive treatments of iron deficiency anaemia in pregnancy: A review of their effectiveness and implications for health system strengthening. J Pregnancy. 2012;2012:454601. doi: 10.1155/2012/454601.

Khaskheli MN, Baloch S, Sheeba A, Baloch S, Khaskheli FK. Iron deficiency anaemia is still a major killer of pregnant women. Pak J Med Sci. 2016;32(3): 630–4. doi: 10.12669/pjms.323.9557.

Tabassum S, KhakwaniM, Fayyaz A, Taj N. Role of Mentzer index for differentiating iron deficiency anemia and beta thalassaemia trait in pregnant women. Pak J Med Sci.2022; 38(4): 878–82. doi: 10.12669/pjms.38.4.4635.

Bose S, Maimoon S. Is Mentzer index a reliable diagnostic screening tool for beta thalassemia trait. IOSR J Dent Med Sci. 2018;17(7):7–11.

Dapper DVB, Ibe CJ, Nwauche CA. Hematologic values in pregnant women in Port Harcourt, Nigeria. Niger J Med. 2007;15(3):237-40. doi:10.4314/njm.v15i3.37220.

Mba CO, Jacob RB, Green MB, Zebedee LU. Hematological Profile of Pregnant Women in Port Harcourt, Nigeria. International Journal of Translational Medical Research and Public Health. 2019; 3(1): 1-10. doi:10.21106/ijtmrph.63.

Amah-Tariah FS, Ojeko SO, Dapper DV. Hematological values in pregnant women in Port Harcourt, Nigeria II: serum iron and transferrin, total and unsaturated iron binding capacity, and some red cell and platelet indices. Niger J Physiol Sci. 2011; 26(2):173-8.

Ndukwu GU, Dienye PO. Prevalence and socio-demographic factors associated with anaemia in pregnancy in a primary health centre in Rivers State, Nigeria. Afr J Prim Health Care Fam Med. 2022; 4(1): 328-9. doi: 10.4102/phcfm.v4i1.328.

Azinge IE, Ogunyemi A, Ogamba CF, Jimoh RO. Prevalence of anaemia and associated factors among adults in a select population in Lagos, Southwest Nigeria. J Public Health Afr. 2023;14(4): 2224. doi: 10.4081/jphia.2023.2224.

Onimawo IA, Onuoha VU. Prevalence of Iron deficiency anaemia among pregnant women in urban and rural areas of Abia State. Pakistan Journal of Nutrition. 2015; 14(9): 553-6.

Published
2024/08/09
Section
Original article