Think Foundation
Knowledge Centre - Role of Laboratories

Ideally a test for Thalassaemia Minor should be done by using the Variant (HPLC) Machine. However, due to the high capital cost of the Machine and the high recurring cost of the reagents used, the test is very expensive. This test does not become financially viable when it comes to screening of the population. Population Screening therefore chooses to go for an initial test for Complete Blood Count (CBC). If the MCV and the MCH are on the lower side, the sample is subjected to a further test on the Variant Machine. Subjecting only the suspect samples to the Variant Machine thus brings down the average cost of the Population Screening test. This two-stepped method is financially feasible for population screening.

Each one of us has undergone a blood test for Complete Blood Count at some stage in life. If a closer look were taken of the indices in the CBC, it would be possible to offer suggestion on further course of action. It may be very much in order to make a suggestion for a further test in the vent of the MCV and MCH being on the lower side. This could be done in the form of a pre-printed remark on the CBC Report. The pre-printed could read as “ If MCV < 78 or MCH < 27 it would be advisable to take a test to rule out Thalassaemia Minor or Iron Deficiency.”

Sensitization of laboratories is easily the most important filter for screening for Thalassaemia Minor from the point of view of easy implementation. There is no extra effort required to be done. When a test for CBC is done, the CBC Report for the laboratory may carry the pre-printed caution relating to lower MCV and MCH. On receipt of a Report, even a layperson who is not conversant with medical details has a tendency to check whether the results fall in the normal range. And if they don’t, he wonders about the next step to be taken.

This action by the laboratory of carrying a pre-printed caution on the CBC Report can result in a large number of people going for a test for Thalassaemia Minor, thereby protecting their future families.