Reliability of Screening Tests against HPLC for the Detection of Sickle Cell Disease in Betul District – A Hospital Based Study from Central India
Reliability of Screening Tests against HPLC for the Detection of Sickle Cell Disease in Betul District
Keywords:
HPLC, screening, sickle cell disease, sickling test, solubility testAbstract
Introduction: The role of laboratory in the diagnosis of haemoglobinopathies is crucial. Sickle cell disease (SCD) is the most common life threatening disease worldwide. Peripheral blood film method, Sickling and Solubility tests are used as screening methods of sickle cell disease. Aim of the study: This study was conducted to determine the reliability of Peripheral blood film; sickling and solubility tests against High pressure Liquid Chromatography as gold standard. Methods: This was a cross sectional laboratory based study carried out at Nidan Diagnostics, Shree Goverdhan Rathi Hospital, Betul. A total of 132 samples of children aged up to 1 year and adults up 30 years were studied over a period of six months. High Performance Liquid Chromatography was used as the gold standard. Results: Sickling, solubility and peripheral blood film tests had sensitivities of 87.5%, 75%% and 81% respectively. Sickling, solubility and peripheral blood film tests had specificities of 95%, 84% and 89.3% respectively. The positive predictive values for Sickling, solubility and peripheral blood film tests were 84.85%, 60% and 70.27% respectively. The negative predictive values for Sickling, solubility and peripheral blood film tests were 95.96%, 91% and 93.68% respectively. Conclusion: The Sickling test was the most reliable, cheapest and easiest to perform; it had high specificity, sensitivity. The solubility test was found expensive, cumbersome and unreliable for sickle cell screening, it had low sensitivity. Sickling would therefore be the most recommended test for screening children for sickle cell disease using HPLC as confirmatory method. [Smita R NJIRM 2017; 8(6):83-86]
References
2. Stuart MJ, Nagel RL. Sickle cell disease. Lancet. 2004; 364:1343–60.
3. Rees DC, Williams TM, Gladwin MT. Sickle cell disease. Lancet. 2010; 376:2018–31.
4. https://www.cdc.gov/ncbddd/sicklecell/documents/nbs_hemoglobinopathy-testing_122015.pdf(Available online, As assessed on 28th September 2017) 5. Surve RR, Mukherjee MB, Kate SL, Nagtilak SB, Wadia M, Tamankar AA, et al. Detection of the beta S gene: an evaluation of the solubility test against automated chromatography and haemoglobin electrophoresis. Br J Biomed Sci. 2000; 57:292–4.
6. L. Okwi, W. Byarugaba, A. Parkes, M. Ocaido. The Reliability of Sickling and Solubility Tests and Peripheral Blood Film Method for Sickle Cell Disease Screening at District Health Centers in Uganda. Clinics in Mother and Child Health. 2010: 7:1-5.
7. Panigrahi S, Patra PK, Khodiar PK. The screening and morbidity pattern of sickle cell anemia in Chattisgarh. Ind J Hematol Blood transfusion. 2015;31(1):104–09.
8. R.G. Schneider, J.B. Alperin, H. Lehmann, Sickling tests pitfalls in performance and interpretation, JAMA. (1967): 202: 419-421.
9. S. Chasen, Z.S. Loeb, and E. Landsberger. Haemoglobinopathy screening in pregnancy: Comparison of two protocols, Am J Perinat. (1999): 16: 175-180
10. M. Robert, M.D. Schmidt, M. W. Sylvia. Standardization in detection of abnormal hemoglobins. Solubility tests for hemoglobins.S.JAMA,225(1973),1225-1230
