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  • Prevalence of Iron Deficiency Anemia and Beta Thalassemia Trait and Sensitivity and Specificity of Complete Blood Count Indices in Differentiation of these Conditions
  • mehdi bakhtiyari,1 Raheleh Derafshi,2 Ali Alami,3 Mohammad Ghorbani,4 Saeede Hosseini,5 Mehdi Karimi-Shahri,6,*
    1. Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    2. Assistant Professor of Pathology, Department of Pathology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
    3. Department of Epidemiology and Biostatistics, School of Health, Gonabad University of Medical Sciences, Gonabad Iran
    4. Hematology and Blood Transfusion, Pathology Department, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
    5. Medical Student, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
    6. Assistant Professor of Pathology, Department of Pathology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran


  • Introduction: Differentiating iron deficiency anemia (IDA) and Beta thalassemia trait (BTT) requires specialized and costly tests. Complete blood count (CBC) may be used for this purpose. This study aimed to estimate the prevalence of these two conditions and the validity of CBC indices in differentiating IDA from BTT.
  • Methods: This descriptive study was conducted on 1000 subjects who were randomly selected from patients who were referred to Gonabad city laboratories for CBC and hemoglobin electrophoresis from March 2018 to March 2019. The collected data included CBC parameters and serum ferritin levels. In case of high ferritin levels, hemoglobin electrophoresis was performed for definitive diagnosis of thalassemias. Sensitivity and specificity of Mentzer, Serivastava and Kerman indices in differentiation of IDA from BTT were evaluated.
  • Results: Prevalence of IDA and BTT were 23.5% and 2.7%, respectively. Sensitivity and specificity of Mentzer index for IDA and BTT were 81.27% and 74.08%, respectively. Sensitivity and specificity of Serivastava index for IDA and BTT were 74.05% and 66.66%, respectively. Finally, the sensitivity and specificity of Kerman index were 84.25% for BTT and 77.79% for IDA.
  • Conclusion: This study showed that Kerman index had the highest diagnostic value for differentiating IDA from BTT followed by Mentzer and Servastava index. These indices can be used as rapid and low-cost diagnostic methods in low-income areas and in the absence of hemoglobin electrophoresis.
  • Keywords: Beta thalassemia; iron deficiency anemia; discrimination indices; sensitivity; specificity