Advertisement

Reply in response to the article neglecting Borderline HbA2 (3.2–3.9%) may impede prevention program for thalassemia

Open AccessPublished:February 02, 2022DOI:https://doi.org/10.1016/j.cegh.2022.100963
      The letter to the editor submitted by Dr. Kumar titled “Neglecting Borderline HbA2 (3.2–3.9%) may impede prevention program for thalassemia” is with latest information on the detection of β-thalassemia. Dr. Kumar mentioned the cut off value for the detection of β-thalassemia is 3.2–3.9%. However, we took the cut off value for the detection of β-thalassemia was >4% on the basis of the references and existent national guidelines.
      • Valiya K.R.
      • Gidwani R.K.
      • Kucha N.P.
      • Goswami F.J.
      • Shah M.M.
      • Prajapati S.A.
      Applicability of different hematological discrimination indices for differential diagnoses of beta-thalassemia trait and iron deficiency anaemia.
      • Needs T.
      • Gonzalez-Mosquera L.F.
      • Lynch D.T.
      Beta thalassemia.
      • Ghosh
      • et al.
      Guidelines for screening, diagnosis and management of hemoglobinopathies.
      Prevention and control of hemoglobinopathies in India -thalassemias, sickle cell disease and other variant hemoglobins.
      The present study was intended for the screening of Sickle Cell Anemia, G6PD deficiency and beta thalassemia in the remote and hill areas of Rajasthan. Complete blood count for RBC indices was not carried out in the study. Therefore, cases of equivocal were not taken in to consideration in the study. This was the limitation of the present study. High prevalence of β-thalassemia among the tribes of Rajasthan has already been reported by Mukherjee.
      • Mukherjee M.
      Contribution of national institute of immunohaematology on tribal health Research.
      There is a single study available on the prevalence of alpha thalasemmia in the tribal population of Rajasthan and 3.07% prevalence of alpha thalassemia was reported among the tribal population of the Aravali hill region.
      • Choubisa S.L.
      • Choubisa D.K.
      • Khare S.
      Alpha thalassaemia (Hb Bart's) in Rajasthan (India).
      The higher frequency of alpha thalasemmia (97%) was reported in the tribes of Maharashtra and its adjacent part in Gujarat by Mukherjee et al.
      • Mukherjee M.B.
      • Surve R.R.
      • Ghosh K.
      • Colah R.B.
      • Mohanty D.
      Clinical diversity of sickle cell disease in western India - influence of genetic factors.
      The suggestion given by Dr. Kumar will be taken in to consideration in future when there will be no limitation on the study conditions.

      Source of funding

      Nil.

      Declaration of competing interest

      None.

      References

        • Valiya K.R.
        • Gidwani R.K.
        • Kucha N.P.
        • Goswami F.J.
        • Shah M.M.
        • Prajapati S.A.
        Applicability of different hematological discrimination indices for differential diagnoses of beta-thalassemia trait and iron deficiency anaemia.
        MedPulse Int J Pathol. 2019; 12 (December 2019): 145-152
        • Needs T.
        • Gonzalez-Mosquera L.F.
        • Lynch D.T.
        Beta thalassemia.
        in: StatPearls [Internet]. Treasure Island (FL). Stat Pearls Publishing, 2012 (2021 Jan)
        • Ghosh
        • et al.
        Guidelines for screening, diagnosis and management of hemoglobinopathies.
        Indian J Hum Genet. 2016; 20 (April-June 2014): 101-119
      1. Prevention and control of hemoglobinopathies in India -thalassemias, sickle cell disease and other variant hemoglobins.
        in: National Health Mission, Guidelines on Hemoglobinopathies in India. Ministry of Health & Family Welfare, Government of India, 2016
        • Mukherjee M.
        Contribution of national institute of immunohaematology on tribal health Research.
        Immuno Haematol Bull. 2013; 44: 3-10
        • Choubisa S.L.
        • Choubisa D.K.
        • Khare S.
        Alpha thalassaemia (Hb Bart's) in Rajasthan (India).
        Haematologia. 2000; 30: 209-213
        • Mukherjee M.B.
        • Surve R.R.
        • Ghosh K.
        • Colah R.B.
        • Mohanty D.
        Clinical diversity of sickle cell disease in western India - influence of genetic factors.
        Acta Haematol. 2000; 103: 122-123