Role of NESTROFT as a Screening Tool for Beta-Thalassemia Trait among Pregnant Women Attending a Tertiary Care Hospital: A Cross-Sectional Study

Abstract

Background

Iron deficiency and thalassemia trait are the most common causes of microcytic hypochromic anemia. Serum

ferritin and hemoglobin electrophoresis are required for the diagnosis of these conditions. These investigations

are costly and not readily available in rural settings. Moreover, investigating a large population will overburden the

health care facilities. Therefore, this study was conducted to determine the role of NESTROFT for identification of

beta-thalassemia trait among pregnant women.

Material and Methods

This cross-sectional study was conducted in the Department of Pathology of a tertiary care hospital for a duration

of two years. All the pregnant women who had microcytic hypochromic anemia were evaluated with NESTROFT

and hemoglobin electrophoresis. The quantitative data was represented as mean ± SD and qualitative data as

frequency and percentage. The t-test was used for analyzing quantitative data and categorical data was analyzed

using the chi-square test. The significant threshold of the p-value was set at <0.05.

Results

Total 312 pregnant women with microcytic hypochromic anemia were evaluated during the study period. The

prevalence of beta-thalassemia trait was 3.85%, and NESTROFT exhibited sensitivity of 75%, specificity of 98%,

positive predictive value of 60.3%, negative predictive value of 98.9%, and a Youden Index of 0.73.There was

statistically significant difference in mean RBC count, mean MCV, mean MCH and mean RDW values among

pregnant women with and without beta-thalassemia trait. Red cell distribution width Index had sensitivity= 66.8%,

specificity= 96.6%, NPV=44.8%, PPV= 98.6%, and Youden Index=0.63.

Conclusion

NESTROFT is a simple and cost-effective screening tool for identification of beta-thalassemia trait among

pregnant women.