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Routine screening for α-thalassaemia using an immunochromatographic strip assay for haemoglobin Bart's.
[alpha-thalassemia]
To
evaluate
an
immunochromatographic
(
IC
)
strip
assay
for
Hb
Bart
's
as
a
routine
screening
test
for
α-thalassaemia
in
area
with
a
high
prevalence
of
thalassaemia
and
haemoglobinopathies
.
A
total
of
300
adult
screen
positive
blood
specimens
were
collected
at
an
ongoing
thalassaemia
screening
programme
in
northeast
Thailand
.
Routine
screening
was
done
using
red
blood
cell
indices
,
osmotic
fragility
,
and
dichlorophenolindophenol
tests
.
The
IC
strip
assay
for
haemoglobin
Bart
's
was
performed
on
all
samples
.
The
result
was
evaluated
against
thalassaemia
genotypes
determined
using
standard
haemoglobin
and
DNA
analyses
.
Of
300
subjects
investigated
,
Hb
and
DNA
analyses
identified
32
with
normal
genotype
.
The
remaining
subjects
carried
thalassaemia
with
as
many
as
16
different
genotypes
.
Hb
Bart
's
was
detected
in
all
cases
,
with
several
α
(
0
)
-
thalassaemia
(
SEA
type
)
related
disorders
.
Of
cases
with
α
(
+
)
-
thalassaemia
,
86
.
1
%
showed
a
positive
result
;
100
out
of
103
 
Hb
E
carriers
,
all
homozygous
Hb
E
and
β-thalassaemia
trait
were
negative
.
Nine
out
of
17
cases
with
β-thalassaemia
/
Hb
E
disease
,
and
one
case
of
double
heterozygote
for
Hb
Q-
Thailand
and
Hb
E
returned
positive
results
.
The
overall
sensitivity
and
specificity
of
the
IC
strip
assay
for
detecting
α
(
0
)
-
thalassaemia
were
100
%
and
73
.
1
%
,
respectively
.
The
results
showed
a
high
sensitivity
for
screening
for
α
(
0
)
-
thalassaemia
using
IC
strip
assay
for
Hb
Bart
's
.
This
simple
method
,
used
in
combination
with
conventional
screening
protocols
,
should
lead
to
a
significant
reduction
in
the
number
of
referral
cases
for
DNA
analysis
.
Cost
effectiveness
in
each
population
should
be
taken
into
consideration
.
Diseases
Validation
Diseases presenting
"simple method"
symptom
alpha-thalassemia
cholangiocarcinoma
gm1 gangliosidosis
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