Prevalence Of Hemoglobinopathies Research Articles

Iowa Newborn Screening Program Experience with Hemoglobinopathy Screening over the Last Two Decades and Its Increasing Global Relevance.

Hemoglobinopathies are the commonest monogenic disorder worldwide, with approximately seven percent of the world population being carriers of hemoglobinopathies. The healthcare utilization impact of thalassemia has resulted in global public health initiatives to screen for hemoglobinopathies, especially sickle cell disease (SCD). The Iowa Newborn Screening Program (INSP) has been in place for more than 50 years with a primary focus on detecting SCD. Recent changes in migration patterns have led to a global distribution of hemoglobinopathies in the western world, which has translated to an increase in the diagnosis of SCD and the incidental detection of non-sickling hemoglobinopathies within the INSP. This study documents the birth prevalence of hemoglobinopathies diagnosed in newborns through the INSP and highlights the need for newborn screening programs to evolve to meet the healthcare needs of underserved, minority populations.

Prevalence of Haemoglobinopathies among Different Populations

Prevalence of Haemoglobinopathies among Different Populations

Haemoglobinopathies: A Review on Statistical Modelling Perspective (Haemoglobinopathies: Statistical Modelling Techniques)

Haemoglobinopathies indicate a group of monogenic disorders. The prevalence of Haemoglobinopathies differs based on geographical regions and is higher in tropical countries. Literature has identified that Haemoglobinopathies are higher in tribal and ethnic groups compared to the general population in India. This narrative review explores the methods to analyse data related to Haemoglobinopathies, identifies the research gaps and gains insights on model building and prediction of Haemoglobinopathies. This narrative review includes articles focusing on Haemoglobinopathies, Anaemia and other related disorders, published from 2008 onwards. Full-text and accessible articles found in relevant databases were included. Statistical and a few other techniques like Logistic Regression, Bayesian Modelling, Genetic Risk Scoring, Structural Equation Modelling, Multilevel Tests, Longitudinal Models, Machine Learning Algorithms and Genotyping methods were used to know the risk of acquiring Haemoglobinopathies and to identify important genetic variants. From the findings, it was observed that many studies were conducted to identify the prevalence of Haemoglobinopathies among the general population, but only few in the tribal population. Models based on machine learning algorithms were used for prediction involving haematological parameters and genetic variants, whereas the statistical techniques for prediction include demographic, nutritional, economic, cultural and social indicators.

Prevalence of Haemoglobinopathy among Young College Students in Anand-Gujarat: A Premarital Screening Program for Carrier Detection of Hemoglobin Disorders

Background: Hemoglobin disorders are the leading health concern in the World including India. Effective screeningprograms, awareness campaign and proper prenatal diagnosis are the only ways to eradicate the disease. Verysparse data are available on the spectrum of haemoglobinopathies in the central part of Gujarat state. Hence, thisstudy was undertaken to find out the prevalence of haemoglobinopathies among the students of Anand People’sMedicare Society, Anand District, Gujarat, India.Methods: In this prospective study, total 2195 students were screened for haemoglobinopathies after takingclinical and familial history. A complete hemogram report was obtained by an automated hematology counterand hemoglobin variants were quantitated by performing HPLC on Bio-Rad Variant II. The prevalence ofhemoglobinopathies was 7.06%, which includes β-thalassemia trait (2.73 %), sickle cell trait (3.82%), homozygoussickle cell disease (0.09%), Hb D trait (0.22%), Hb E (0.09%) trait and other haemoglobinopathies (0.08%).Conclusion: Population groups with high gene frequency of haemoglobinopathies requires a routine premaritalscreening program, awareness and education for identification, prevention of high-risk marriages and birth ofthalassemic homozygotes.

Prevalence of Hemoglobinopathy in Adult Population at KAMC, Riyadh, Saudi Arabia

Prevalence of Hemoglobinopathy in Adult Population at KAMC, Riyadh, Saudi Arabia

Screening of antenatal patients for anaemia and haemoglobinopathies

Introduction: Anaemia is an extremely common condition in pregnancy worldwide, conferring a number of health risks to mother and child. Iron deficiency is most widespread micronutritional deficiency in the world and disproportionately affects female because of increased iron requirements during menstruation, pregnancy and lactation. Haemoglobinopathies are a group of inherited disorders because of abnormalities in haemoglobin synthesis or structure. Thalassemia and Sickle cell anaemias are the most prevalent haemoglobinopathies and a national health burden in India so identifying these disorders during antenatal period is necessary to take appropriate measures. Methods: A prospective study of screening for haemoglobin variants in Antenatal Patients due to low haemoglobin and evaluation of other causes was performed for 1 year with 570 samples. In Low Hb patients’ CBC, Reticulocyte staining and sickling test was performed. Haemoglobin analysis was done by HPLC BIO RAD VARIANT II. In Iron Deficiency Anaemia (IDA) Serum ferritin & Serum Iron level were done and in Megaloblastic Anaemia(MA) Vitamin B12 level were done. Result: Prevalence of anaemia in antenatal patients was 90.25%; in this IDA presented with 84.21%, MA with 4.73% and Dimorphic anaemia 1.27%. Prevalence of haemoglobinopathies in this study was 9.75%; in this Beta Thalassemia Minor present with 5.08%, Sickle Cell Trait 4.03%, Hb D Punjab 0.52% and Hb Q india 0.17%. Conclusion: Antenatal screening for genetic disorders, such as Beta thalassemia, Sickle Cell Anaemia, aims to reduce the burden of these diseases by offering information to individual with a high likelihood of giving birth to affected babies and giving parents more choices regarding their reproductive decisions. For this, premarital and antenatal screening should be mandatory to prevent the birth of affected offspring.

Clinical significance of mutational variants in beta and alpha genes in patients with hemoglobinopathies from two large Greek centers: a complex interplay between genotype and phenotype.

Hemoglobinopathies affect patients in the wider Mediterranean area consisting of 4 distinct subgroups: beta thalassemia major (TM), beta thalassemia intermedia (TI), sickle cell disease (SCD) and hemoglobin H disease (alpha thalassemia). The clinical spectrum varies from mild to severe. Complex interactions between genes and environmental factors form the clinical manifestations. There is an unmet need to clarify these multifactorial mechanisms.This is the first Greek study describing mutational alleles (HBB and HBA1/HBA2 gene variants) in 217 patients with hemoglobinopathies of two large centers in Greece (Larissa and Athens) and associating particular genotypes or gene variants with clinical manifestations (transfusion frequency, complications). Thus, the complex interplay between corresponding genotypes and phenotypes was investigated.Our results are in accordance with previous national studies with limited variations, due to regional prevalence of specific gene variants, as expected. It is also a description of the prevalence of hemoglobinopathies in the Greek population. The type and prevalence of beta and alpha globin gene variants differ significantly among countries. We also confirm the well-known observation of many studies that in our beta thalassemic or SCD patients, co-inheritance of variants in the alpha globin genes, leading to absence or reduction of alpha globin synthesis were associated with milder clinical course, whereas the inheritance of additional alpha genes (triplication) led to a more severe clinical phenotype.In cases in whom the genotype and phenotype did not correlate, factors like the function or modification of possible regulatory genes or additional nutritional-environmental effects should be investigated. KEY MESSAGES: • This is the first Greek study, fully molecularly defining the beta and alpha mutational alleles in 217 patients with hemoglobinopathies of two large centers in Greece and correlating particular genotypes or gene variants with clinical manifestations (transfusion frequency, complications). • In the beta thalassemic or SCD patients of our cohort, co-inheritance of variants in the alpha globin genes, leading to absence or reduction of alpha globin synthesis were associated with milder clinical course (confirmation of a well-known previous observation). • The inheritance of additional alpha genes (triplication) led to a more severe clinical phenotype (confirmation of a well known previous observation). • The function or modification of possible regulatory genes should be investigated in cases in whom the genotype and phenotype did not correlate.

Prevalence of Hemoglobinopathies in Premarital Screening in the Province of Nigde, Turkey

Hemoglobinopathies are one of the most widespread hereditary disorders in Turkey. The present study aimed to determine the prevalence of hemoglobinopathies in the Nigde province of Turkey. This study was conducted with 2013 individuals who applied for the premarital screening, between January 2019 and December 2021. The complete blood count was measured by an automated hematology analyzer. The types of hemoglobin were determined by high-performance liquid chromatography. A total of 2013 individuals including 951 (47.2%) females and 1062 (52.8%) males, were screened within the premarital screening program, and 67 (3.3%) of them were migrants. 53 out of 2013 (2.63%) individuals were identified as β thalassemia carriers, and five of them were migrants including two from Afghanistan, two from Iran, and one from Georgia. HbC was observed in two cases, a couple from Syria (0.1%), HbD in two cases (0.1%), HbE in one case from Thailand (0.05%), HbS-β-thalassemia in one case (0.05%), delta-β thalassemia in one case (0.05%), and unidentified structural variant in one case (0.05%). Moreover, 183 individuals (9.1%) were considered to have iron deficiency, α-thalassemia, or silent β-thalassemia carrier. These results indicate that the province of Nigde is a relatively risky region regarding hemoglobinopathies. Geographic location and immigrant population may have slightly affected the local prevalence of hemoglobinopathies and could be taken into consideration to ensure the effective implementation of the hemoglobinopathy prevention program.

Role of premarital screening program in detection of hemoglobinopathies at Al Baha, Saudi Arabia

Background: Hemoglobinopathies are prevalent in Saudi Arabia. The use of high-performance liquid chromatography (HPLC) for screening of these disorders has recently been undertaken. This study was conducted to estimate the prevalence of hemoglobinopathies and evaluate the role of premarital screening centers among residents of Al Baha province, Saudi Arabia. Methods: This retrospective cohort study utilized the laboratory reports of couples attending the premarital screening centers for the screening and confirmation of hemoglobinopathies in Al Baha province, Saudi Arabia. We obtained data from four hospitals and three primary healthcare centers authorized to perform these screening tests. Results: The current study screened and analyzed a total of 2,165 reports for suspected hemoglobinopathies. Only 121 (5.6%) reports showed abnormal hemoglobin (Hb) patterns, among which the sickle cell trait was the most common, representing 59.5% (72/121) of the reported cases. This was followed by the β-thalassemia trait, Hb Lepore, sickle cell disease, and β-thalassemia major, accounting for 32.2% (39/121), 3.3% (4/121), 2.5% (3/121), and 2.5% (3/121), respectively. Conclusion: Sickle cell and β-thalassemia traits are the major hemoglobinopathies in Al Baha, Saudi Arabia. Premarital screening is an invaluable measure to prevent childbirth with severe Hb disorders. The use of HPLC in the screening process provides a rapid, reliable procedure for the identification of various Hb fractions.

Premarital Screening for Thalassemia Among Young Adults: A Study in Zabol, Sistan and Baluchistan Province of Iran

Introduction: There is a high prevalence of hemoglobinopathies, including thalassemia, in Sistan and Baluchistan province of Iran. It is important to appropriately screen young adults to control the birth of new cases of thalassemia. In many less-equipped centers, this practice only relies on cell blood count. This study investigated the hematological parameters of young adults referring to the Central Laboratory of Sistan, Zabol, for premarital screening for thalassemia. Methods: This was a descriptive cross-sectional study conducted in Zabol, Sistan and Baluchistan province of Iran from August 2020 to August 2021. Complete blood count (CBC) parameters of 2926 young adults were collected using a Sysmex KX-21 device and were compared with available reference intervals according to the Clinical and Laboratory Standard Institute. Results: The means of women’s and men’s age were 38.84±16.32 and 36.64±14.14 years, respectively. The average values for each parameter in the studied population were red blood cell (RBC) (4.78±0.55), hemoglobin (13.19±2.46 g/dL), hematocrit (40.11±3.57%), mean corpuscular volume (MCV) (85.16±28.33), neutrophil (52.12±9.98), lymphocyte (37.84±9.03), mixed leukocytes (10.00±3.51), platelets (244.02±62.32). The mean values of hemoglobin (14.48±5.17 vs. 12.69±1.39 g/dL), hematocrit (43.01±3.89 vs. 38.97±3.45%), serum ferritin (115.4±74.3 vs. 69.20±12.36 g/dL), total iron-binding capacity (316.84±1.38 vs. 320.95±41.01, P=0.01), and serum iron (85.05±28.51 vs. 76.25±28.22, P=0.02) were significantly lower in women than in men. Out of 2,926 people who entered this study, 195 (6.66%) were suspected of having thalassemia because of their low MCV (71.61±7.33 fL) and mean corpuscular hemoglobin (MCH) (23.67±2.66 pg). Conclusion: The relatively low hemoglobin in females referring for premarital screening for thalassemia awakens healthcare experts to carefully examine these cases for the possibility of thalassemia minor after excluding other common possible reasons such as iron deficiency anemia using iron studies and hemoglobin electrophoresis.

Hematological Parameters and Demographic Distribution of Hemoglobinopathies and Various Hemoglobin Variants.

Background The study was conducted to find the prevalence of hemoglobinopathies along with their geographical/ethnic distribution to highlight the region of high prevalence that can be used to guide screening. Method Results of blood samples received for hemoglobin variants determination by high-performance liquid chromatography (HPLC) were retrospectively analyzed at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. Blood samples were assayed for CBC (complete blood count), red blood cell morphology, and hemoglobin analysis by HPLC. CBC was performed on Sysmex XN 9000 analyzer (Sysmex, Kobe Japan), peripheral smears to review RBC morphology were stained with Wright-Giemsa stain, and HPLC was performed on BIO-RAD variant II (Bio-Rad Laboratories, Hercules, USA). Results Hemoglobinopathies were identified in 9.7% (n=997) out of 10,297 samples. Beta thalassemia trait was the most common hemoglobinopathy recognized with a prevalence of 5% (n=516), with the maximum number of cases in the Lahore district of Punjab province. The next most common hemoglobinopathy identified was sickle cell disease with a frequency of 1.43% (n=148) and the maximum cases from the Dera Ismail Khan district of the Khyber Pakhtunkhwa province. The additional important hemoglobinopathies found were sickle cell trait, hemoglobin-D Punjab trait, and compound heterozygote for sickle and beta thalassemia. Conclusion Hemoglobinopathies are the most common inherited disorders in Pakistan and worldwide. Screening for hemoglobinopathies is recommended in high-prevalence districts of Pakistan. Sickle cell screening is also recommended in newborns in the high prevalence area of Pakistan, such as the northwest regions.

High-performance liquid chromatography local reference ranges of hemoglobin fractions (HbA, HbA2, and HbF) in detection of hemoglobinopathies in western Kenya

High-performance liquid chromatography local reference ranges of hemoglobin fractions (HbA, HbA2, and HbF) in detection of hemoglobinopathies in western Kenya

A community based study on haemoglobinopathies and G6PD deficiency among particularly vulnerable tribal groups in hard-to-reach malaria endemic areas of Odisha, India: implications on malaria control

BackgroundHaemoglobinopathies and G6PD deficiency are inherited disorders found mostly in malaria-endemic areas among different tribal groups of India. However, epidemiological data specific to Particularly Vulnerable Tribal Groups (PVTGs), important for planning and implementing malaria programmes, is limited. Therefore, the present community-based study aimed to assess the prevalence of haemoglobinopathies and G6PD deficiency among the 13 PVTGs found in the state of Odisha, reporting the maximum malaria cases in the country.MethodsThis cross-sectional study was conducted from July 2018 to February 2019 in 12 districts, home to all 13 PVTGs, in an estimated sample size of 1461, selected two-stage sampling method. Detection of haemoglobinopathies was done by the variant analyser. Screening of G6PD deficiency was carried out using DPIP method followed by quantification using spectrophotometry. The PCR–RFLP technology was used to determine variant of G6PD deficiency and haplotype analysis of sickle cell, while ARMS-PCR and GAP-PCR was used for detecting the mutation pattern in β-thalassaemia and α-thalassaemia respectively. The diagnosis of malaria was done by Pf-PAN RDT as point of care, followed by nPCR for confirmation and Plasmodium species identification.ResultsThe prevalence of sickle cell heterozygotes (AS) was 3.4%, sickle cell homozygous (SS) 0.1%, β-thalassaemia heterozygotes 0.3%, HbS/β-thalassaemia compound heterozygote 0.07%, HbS-α-thalassaemia 2.1%, G6PD deficiency 3.2% and malaria 8.1%. Molecular characterization of βS revealed the presence of Arab-Indian haplotype in all HbS cases and IVS 1–5 G → C mutation in all β-thalassaemia cases. In case of α-thal, αα/α-3.7 gene deletion was most frequent (38%), followed by αα/α-4.2 (18%) and α-3.7/α-3.7 (4%). The frequency of G6PD Orissa (131C → G) mutation was found to be 97.9% and G6PD Mediterranean (563C → T) 2.1%. Around 57.4% of G6PD deficient individuals and 16% of the AS were found to be malaria positive.ConclusionThe present study reveals wide spread prevalence of sickle cell anaemia, α-thalassaemia, G6PD deficiency and malaria in the studied population. Moderate to high prevalence of G6PD deficiency and malaria warrants G6PD testing before treating with primaquine (PQ) for radical cure of Plasmodium vivax. Screening and counselling for HbS is required for the PVTGs of Odisha.

STUDY OF SPECTRUM OF HEMOGLOBINOPATHIES IN ADULT AGE GROUP DIAGNOSED ON HIGH PERFORMANCE LIQUID CHROMATOGRAPHY IN TERTIARY CARE HOSPITAL

Background: Inherited abnormalities of hemoglobin synthesis (hemoglobinopathies) include a myriad of disorders ranging from thalassemia syndromes to structurally abnormal hemoglobin variants. Aims and Objectives: To study spectrum of hemoglobinopathies in adult age group diagnosed on HPLC in tertiary care hospital. Materials and Methods: The present study carried out in the deparment of pathology , DR PDMMC AMRAVATI over a period of 18 months from january 2021 to june 2022. A total of 800 cases were included in the present study. The age group of patients ranged from 19 years and above. HPLC , complete blood count, and peripheral smear examination were done in all the cases. Results and Discussion: In the present study total 800 patients were included out of which 134 cases displayed abnormal hemoglobin fractions on HPLC. It was seen that majority of the patients in study were in the 19yrs to 30yrs. The most common hemoglobinopathy observed in the present study was sickle cell trait (51.50 %) followed by Beta Thalassemia trait (26.12 %) and Sickle cell disease (16.42 %).HbDpunjab trait was observed in 3.74 % cases. Sickle cell Disease + Beta thalassemia trait ,HbE trait, HbE homozygous were observed in 0.74% cases each. Conclusion: Detection of β-thalassemia carriers and other structural variants will provide a preliminary insight to the prevalence of hemoglobinopathies in hospital based patients.Awareness can be created in an effort to prevent the birth of affected children.The present study is intended to contribute to the available data as the identification of these disorders is important epidemiologically and aids in prevention of more serious hemoglobin disorders.

Hemoglobinopathy screening in primary care in the Netherlands: exploring the problems and needs of patients and general practitioners

The prevalence of hemoglobinopathies in The Netherlands is increasing due to migration. Hemoglobinopathies are severe hereditary diseases. An informed reproductive choice by at-risk couples, such as pre-implantation diagnosis or termination of affected pregnancies, can be made if carriers are detected prior to conception. Using a qualitative design, the needs and wishes of patients, carriers and general practitioners were evaluated regarding carrier detection of hemoglobinopathies in primary care practice. 30 semi-structured interviews were established with 10 general practitioners, 10 patients and 10 carriers. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis to identify recurring themes. Three themes were generated regarding carrier detection of hemoglobinopathies: (1) a need for more information about hemoglobinopathy, (2) a need for indications when to refer for analysis (carrier diagnostics) and (3) insight concerning organization and roles in care for hemoglobinopathy carriers and patients. These themes reflected a need to increase awareness of hemoglobinopathy, improve competences among general practitioners through better education and improvement of communication with patients and their unidentified family members. This study shows the scope of the problem and the critical need for action to improve informed reproductive decision making for the at-risk population.

Hemoglobinopathy prevention in primary care: a reflection of underdetection and difficulties with accessibility of medical care, a quantitative study

As in most Northern European countries, the prevalence of hemoglobinopathies in The Netherlands is increasing due to migration. Although hemoglobinopathies are severe chronic diseases with few treatment options, timely detection of carriers allows at-risk couples to make informed reproductive choices such as pre-implantation diagnosis, prenatal diagnosis or termination of affected pregnancies. Using a quantitative design, we evaluated the prevalence of hemoglobinopathies in The Hague region, The Netherlands. Patient and carrier registries from hospital, laboratory and general practitioners allowed this quantitative analysis. The highest prevalence of hemoglobinopathies was seen in immigrant neighborhoods, and a large gap was noted between estimated carrier prevalence and the actual registration of carriers in electronic patient records. Carrier prevalence was estimated to be 13,704; however, the ELAN database contains only 1542 cases with ICPC codes for sickle cell disease or thalassemia. Although more research is needed to define the requirements of the healthcare system to address this challenge, this study clearly shows the gap between estimated carrier prevalence and registration and thereby the pressing need for action.

Prevalence of Haemoglobin Variants and Haemoglobinopathies in a Single Paediatric Centre in Southern India: A Retrospective Cross-sectional Study

Introduction: Haemoglobinopathies are qualitative disorders of Haemoglobin (Hb) resulting from structural defects in the amino acid sequence of one of the globin chains, whereas, thalassaemia results from quantitative defects in the synthesis of one or more of the globin chain subunits of the Hb tetramer. Cation Exchange- High Performance Liquid Chromatography (CE-HPLC) is one of the methods for initial screening of Hb variants like HbS, HbD, HbE etc and for quantification of HbF, HbA and HbA2 levels. Aim: To find out the prevalence of haemoglobinopathies in patients of a Government paediatric tertiary care hospital in south India. Materials and Methods: In this retrospective, cross-sectional study, all laboratory requests, in the period from August 2019 to July 2021, for Hb variant analysis by HPLC were collected, irrespective of provisional diagnosis. The Hb variant analysis was carried out by CE-HPLC on the Bio-Rad D-10 analyser. This study was conducted in a Government Paediatric tertiary care hospital in Southern India for patients who had any clinical or familial suspicion of haemoglobinopathies. The Statistical analysis was performed using Microsoft Excel 2010. Results: Total data of 704 laboratory requests for Hb Variant analysis were obtained. Out of 704 laboratory request, 585 were from children younger than 12 years of age and 119 were parental screening. There were 164 abnormal chromatograms. Out of 164 patients, 91 were female patients and 73 were male patients. Out of 164 abnormal chromatograms, 97 (59.15%) were beta- thalassaemia trait, 18 (10.98%) were beta-thalassaemia major, 13 (7.93%) were sickle cell trait, 2 (1.22%) were sickle cell disease, 21 (12.80%) were HbE trait, 2 (1.22%) were homozygous HbE, 2 (1.22%) were HbD trait, 3 (1.83%) were Hereditary Persistence of Foetal Hb (HPFH)/delta beta-thalassaemia, 2 (1.22%) were HbJ trait, 1 (0.61%) was HbE beta-thalassaemia, 1 (0.61%) was sickle- beta-thalassaemia and 2 (1.22%) were alpha thalassaemia. Conclusion: From this study, beta-thalassaemia trait and beta- thalassaemia major were found to be the first and second most prevalent haemoglobinopathies in children below 12 years of age. This data suggests the importance of premarital and antenatal screening procedures that can help in reducing the possibility of such haemoglobinopathies in the future generation, suffering and burden of disease to the family and society.

Pattern of hemoglobinopathies in females attending in antenatal clinic with special reference to the role of RBC parameters in beta-thalassemia carrier detection

Background: Hemoglobinopathies are the major cause of anemia throughout the world complicating pregnancy outcome. Hence, detection of hemoglobinopathies in antenatal period is of critical importance as it not only predict the possibility of birth of a child with thalassemia but also reduces the complications associated with anemia in pregnancy. Hence, identification of a reliable cost-effective screening method for detection of hemoglobinopathies is of utmost importance. Aims and Objectives: The present study was conducted to evaluate the role of red blood cell (RBC) parameters including hemoglobin (Hb%), RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in detection of thalassemia carriers among healthy antenatal mothers in a tertiary care hospital of Eastern India. Materials and Methods: Venous blood samples were collected from total 1458 antenatal mothers aged 18 years or above with <17 weeks of gestation and were analyzed for complete blood count, serum ferritin level, and high-performance liquid chromatography for identification of abnormal Hb. Patients with iron deficiency anemia as diagnosed by serum ferritin <15 ng/ml were excluded from this study. Results: The prevalence of hemoglobinopathy was found to be 12.55% with ß-thalassemia trait (BTT) being the most common type (7.9%). All the RBC parameters were significantly lower among the BTT group compared to individuals with normal or other hemoglobinopathies (P < 0.05). Conclusion: RBC parameters such as Hb, RBC, MCV, and MCH can be used as cost-effective yet very effective screening method to identify different hemoglobinopathies among antenatal mothers.

Prevalence of hemoglobinopathies using high-performance liquid chromatography as diagnostic tool in anemic patients of tertiary care center of Western India

Prevalence of hemoglobinopathies using high-performance liquid chromatography as diagnostic tool in anemic patients of tertiary care center of Western India

Estimation of the prevalence of Hemoglobinopathies in Erbil governorate, Kurdistan region of Iraq

Estimation of the prevalence of Hemoglobinopathies in Erbil governorate, Kurdistan region of Iraq