Use of Red Cell Distribution Width Index for Screening and Differentiation of Iron Deficiency Anemia and Beta Thalassemia Trait

Abstract

Background: Iron deficiency anemia (IDA) is one of the common nutritional disorders in the world. In the subcontinent Microcytic hypochromic anemia is usually caused by beta thalassemia trait (BTT) and iron deficiency anemia (IDA). IDA may be confused with BTT. It is important to distinguish between the above conditions to avoid unnecessary iron therapy in thalassemia carriers. Red cell distribution width index (RDWI) are a simple, easy, and cost effective method to get a primary and valuable information regarding the diagnosis of IDA and BTT. Objective: To assess the predictive value of Red cell distribution width index (RDWI)) for differentiation of Iron Deficiency Anaemia and Beta Thalassaemia Trait.Material & Methods:The study was a cross-sectional descriptive study which was conducted in Department of Clinical Pathology, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh. Over a period of April 2019 to September 2020. The newly clinically diagnosed cases of BTT and IDA were selected for this study. The sample size was 110. Among them 46 cases were identified as BTT and 64 were IDA. Data were analysed using a computer programme SPSS 25.0 version.Results:Total 110 respondents were included in the study. Among them 46.4% were female and 53.6% were male. About 72.72 % of respondents were aged 1 to 10 years old, while 10% were aged 11 to 20 years old and 10% were aged 21 to 30 years old. 4.54 % were between the ages of 31 to 40, as well as those over 40. The average age (SD) was 22.0 ± 32.52. Mean (±SD) age was 22.0 ± 32.52. RDWI had both sensitivity and specificity more than 80% in detection of BTT and IDA. Sensitivity, specificity of RDWI index for detection of BTT was found 81.0%, 83.8%. In case of IDA, sensitivity and specificity was found 83.8% and 81.0% respectively.Conclusions:The current study found that multiple discriminants can be used to differentiate between iron deficiency anemia and the Beta Thalassaemia Trait. RDWI could be a better way to tell the difference between BTT and IDA.