ABSTRACT
In order to obtain an appropriate control measure for thalassemia and iron deficiency anemia, it is necessary to estimate the health burden in the relevant area. This study aimed to determine the prevalence of thalassemia and iron deficiency in pregnant women attending antenatal care service at Khaowong Hospital, Kalasin province, in which the majority of pregnant women is the “PhuTai” ethnic group. Blood samples taken from 302 pregnant women were investigated for hematological parameters using an automated blood cell counter to diagnose anemia. For the diagnosis of iron deficiency, measurement of ferritin was done by chemiluminescent immunoassay. Hb analysis using cellulose acetate electrophoresis and/or capillary zone electrophoresis was performed to diagnose b-thalassemia and abnormal hemoglobin (Hb). Alpha-thalassemia genes including Hb Constant Spring (Hb CS) and Hb Pakse’ were identified by the polymerase chain reaction and related technologies. Of the 302 subjects, 36.4 % (95% CI = 31.0-42.1) had anemia, 42.0 % (95 % CI = 32.2-52.3) had iron deficiency and 17.0 % (95 % CI = 10.2-25.8) had iron deficiency anemia. Alpha-thalassemia 1 was found in 9.6% (95% CI = 6.5-13.5), comprising 9.3 % SEA deletion and 0.3 % THAI deletion. The prevalence of a-thalassemia 2 was 27.0 % (95 % CI = 18.6-36.8), comprising 14.0 % 3.7 kb deletion, 1.0 % 4.2 kb deletion and 12 % Hb CS. While 43.7 % (95 % CI = 38-0-49.5) of the subjects were Hb E carriers, only 0.3% (95 % CI = 0.0-1.8) were b-thalassemia carriers. The findings demonstrate the health burden in relation to thalassemia and iron deficiency anemia and indicate a need for appropriate measure to control the disease in this ethnic group.
ABSTRACT
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ABSTRACT
At present, an automated hemoglobin (Hb) analyzer has been used widely for determining the Hb profiles. The aim of this study was to compare Hb Bart ‘s and Hb E levels obtained from the 2 different automated-HPLC-analyzers. One hundred and seventy-nine cord blood samples suspected of having Hb Bart’s and Hb E determined by the Primus CLC 330 (Primus Corp, MO, USA.) were recruited. These samples were analyzed again by the Variant Hemoglobin Testing System (Bio-Rad Laboratories, CA, USA.) in which the data processor was modified to quantify the amount of Hb Bart’s. All samples were investigated for α-thalassemia 1 (SEA and THAI deletions), α-thalassemia 2 (3.7 and 4.2 kb deletions), Hb Constant Spring (Hb CS) and Hb Paksé as well as Hb E genes. Analysis of the difference-values of Hb Bart’s and Hb E levels obtained from the 2 systems revealed a median (95% CI) of -0.2 (-0.3, -0.1) for Hb Bart’s and -0.15 (-0.3, -0.05) for Hb E indicating that these values were significantly different (P \< 0.001 for Hb Bart’s and P = 0.008 for Hb E; Wilcoxon sign rank test). Comparison of Hb Bart’s and Hb E levels according to the thalassemia genotypes showed a lower trend of the values obtained from the Primus in almost all genotypes. However, statistical analysis of Hb Bart’s in a group of α-thalassemia 1 newborns showed no significant difference (11.7 ± 2.0 % vs 12.1 ± 2.5 %). The results indicated that Hb Bart’s level obtained from these 2 systems might be used comparatively for screening of α-thalassemia 1 in newborns.
ABSTRACT
To improve the efficiency of thalassemia screening, problems related to the screening procedures had been assessed in 3 community hospitals i.e. Thatako Hospital; Nakornsawan province, Lansaka Hospital; Nakhon Si thammarat province, and Borabue Hospital; Mahasarakham province. The investigation was done in 3 phases. Phase I aimed to identify the problems of routine thalassemia screening. From each hospital, blood samples screened for routine services were collected and sent to the Thalassemia Research Project, the Center for Research and Development in Medical Diagnostic Laboratory (CMDL) at the Khon Kaen University for confirmation. False positive and false negative rates were determined to assess the accuracy of the results. It was found that the range of false positive and false negative rates of the osmotic fragility test (OF test) for screening of α-thalassemia 1 and β-thalassemia was 7.9-29.6% and 0-100%, respectively. The DCIP precipitation test (DCIP-test) used for Hb E screening resulted in a range for false positive results of 1.4-4.0% and for false negative results of 3.6-50%. A combination of the OF/DCIP test revealed 10.5 to 29.6% false positive- and 3.5 to 42.9%, false negative results. In phase II the causes for the measuring errors were identified. These varied from hospital to hospital. Most of the causes were related to mistakes made by the laboratory personnels. A workshop on thalassemia screening was convened to improve the skills of the laboratory staff to perform screening tests correctly. Modified laboratory procedures were implemented in each hospital. Reassessment of the efficiency of thalassemia screening was conducted again by collecting blood samples screened for thalassemia from each hospital and sent to the CMDL for confirmation. The sensitivity and specificity of the combined tests increased considerably from 57.1-96.6% to 97.1-100% and 70.4-88.9% to 81.5-89.9% indicating that the efficiency of thalassemia screening had been improved. The results indicated that the proficiency testing system should be implemented at community hospitals to standardize and improve the quality of thalassemia and hemoglobinopathies screening within Thailand.
ABSTRACT
A cross-sectional study was conducted to describe dietary intake of elderly in the slum areas of Khon Kaen Metropolitan district. The subjects were 78 elderly people. The data were collected by using 24-hours dietary recall, frequency of food intake, and in-depth interview. INMUCAL program was used for calculating nutrient intake. The quantitative data were presented by descriptive statistics. The association between related factors and dietary intake was determined using Chi-square test. Qualitative data analyses were performed using content analysis. The results revealed that the majority consumed sticky rice, white rice, fish, vegetable, fruit, coffee, food seasoning, and MSG by 100%, 57.7%, 70.5%, 46.2%, 37.2%, and 98.7% respectively. Chronic illness was significantly related to nutritional intake