Performance of thalassemia screening program for identification of at-risk couples at Prayuen Hospital, Khon Kaen province

Abstract

Complying with national policy of the Ministry of Public Health, Prayuen Hospital has implemented thalassemia screening program since 2006. Based on the operational guidelines, pregnant women attending antenatal care service are screened for thalassemia using OF/DCIP approach. In case of positive results, the husbands are requested to be screened for thalassaemia as well. Accordingly, blood samples of the positive-screened couples are referred to the Regional Medical Sciences Center, Khon Kaen, to investigate further whether they have true risk. In order to evaluate the performance of thalassemia screening program conducted at Prayuen Hospital during 2006-2008, a retrospective data on the number of the first-visit pregnant women, number of positive screened couples as well as number of the at-risk couples were collected. The positive rate of thalassemia screening, the percentage of screened husbands and the positive rate of at-risk couples were calculated. It was found that the rate of positive screened women in 2006, 2007 and 2008 was 53.5 %, 49.3 % and 53.9 %, respectively. Of the positive-screened women, 56.6 %, 76.1 % and 70.8% of the husbands had been screened for thalassemia. During these 3 fiscal years, a total of 260 couples were gathered. Among them, 8 (3.1 %) were at risk of having babies with severe thalassemia diseases, i.e. 6 at risk of b-thalassemia / Hb E and 2 at risk of homozygous a-thalassemia 1. The expense of laboratory identification of at risk couples was 62,500 baht/year (0.9 % of treatment expense for 1 patient). The results demonstrated that Prayeun Hospital had good performance and complied with the goal of the Ministry of Public Health in that at-risk couples were identified. Consequently, the births of new cases with severe thalassemia diseases could be prevented. However, risk assessment based on Hb analysis revealed that approximate 25% of the positive screened couples were at risk of having babies with non-severe disease, i.e. homozygous Hb E. Therefore, a simple strategy for screening out of these couples is needed to reduce unnecessary expenses of laboratory confirmation.