Prevalence Of Hb E Among Adolescents In Basic Education High School, Anisakhan, Pyinoolwin Township
Abstract
Haemoglobin (Hb) E is the most common Hb variant found among Southeast Asian populations. Myanmar also has high prevalence of important haemoglobinopathies: Hb E – 1 to 28.3% accounting for 1 to 4.9 births per 1000 infants with a major haemoglobinopathy. This study was conducted to determine the prevalence of Hb E among adolescents in Basic Education High School, Anisakhan, PyinOoLwin Township. This community-based cross-sectional descriptive study was done in Myanmar adolescents in 2017. A total 290 apparently healthy high school students in which male 140 (48.3%) and female 150 (51.7%) studying in Basic Education High School, Anisakhan, PyinOoLwin Township, Mandalay District, Myanmar were involved. Then,three milliliters of venous blood samples were taken andHb E by NESTROFT (Naked Eye Single Tube Red Cell Osmotic fragility test) and DCIP (Di ChlorophenolIndol Phenol precipitation) test were done for screening and then Isoelectric focusing (IEF) method was done for confirmation of Hb E to above either of the two positive screening samples. Data entry and analysis was done by SPSS software 20.0 version.The overall prevalence of Hb E trait and Hb E disease was 15.5% (45/290) and 19 cases were observed in male (42.2%) and 26 cases were found in female (57.8%).Among 290 participants, 53 (18.3%) were positive with NESTROFT but not with the DCIP; 17 (5.9%) were negative with the NESTROFT but positive with DCIP; 61 (21.0%) were positive with both tests and 159 participants (54.8%) were negative with both tests.Among 131 participants, in either of the two positive cases, both positive (Positive/ Positive) 61 cases gave 23 cases (37.7%), (Positive/Negative) 53 cases gave 16 cases (30.2%) and (Negative/Positive) 17 cases gave 6 cases (35.3%) as identified as Hb E of total 45 cases (45/131, 34.3%)in which 41 samples (31.3%) were Hb E trait and 4 samples (3.1%) were Hb E disease.Therefore, this study highlighted that one of the main causes of anaemia was haemoglobinopathy and remains a common health problem among adolescents.
Key words: Hb E, high school students, NESTROFT, DCIP,
Comment
Prevalence HbE research was well done in this article and result was similar to overall prevalence of Myanmar. The combined screening tests, NESTROF (Naked Eye Single Tube Red Cell Osmotic fragility test) and DCIP (Di Chlorophrnollndol Phenol precipitation), were positive in either one of these tests could be evaluated for HbE trait and HbE disease,Hb E careers by IEF (Isoelectric Focusing) method.
HbE trait does not usually result in health problem, there may be low MCV and Target cells in blood film. For an infant with HbE trait on two new born specimens, no further test is necessary. However, it is strongly recommended to screen for HbE trait in parents to avoid at risk for subsequent children with Hb E/ß thalassaemia, which is inherited with autosomal recessive.
Hb E disease is due to haemoglobin E gene inherited from both parents and it is a benign form.
It is important to screen HbE carriers that childrenco-inherited haemoglobin E and ß thalassaemia genesfrom parents can cause more serious haemoglobin E/ß thalassaemia disease which is most prevalent in Myanmar with career frequency of around 50%.
NESTROF and DCIP tests were simple, reliable, economically appropriate, practically useful methods and they could be used for screening of Hb E careers.
Maung Maung Htay
MBBS, MMedSc (Int Med),
MMed (NUS, Singapore),
MRCP (UK), MAcadMED (UK),
Parami General Hospital
Khin Moe Aung1, MyintMyint Khaing2, Tin Moe Khaing3, Nilar Wynn4, Khin Saw Aye5
Khin Moe Aung1 – M.B.,B.S, M.Med. Sc, PhD (Pathology)
Deputy Director/ Head, Pathology Research Division, DMR (POLB)
MyintMyint Khaing2 – BSc (Chemisty)(UDE)
Research officer, Pathology Research Division, DMR (POLB)
Tin Moe Khaing3 – BSc (Chemisty)(UDE)
Research officer, Immunology Research Division, DMR (POLB)
Nilar Wynn5 – M.B.,B.S, M.Med. Sc, PhD (Pathology)
Professor/ Head, Department of Pathology, Mandalay General Hospital
Khin Saw Aye6 – M.B.,B.S, M.Med. Sc, PhD (Pathology), FRCP (Glasg)
Deputy Director General (Retired), DMR (POLB)
