Wongprachum Kasama, Sanchaisuriya Kanokwan, Vidamaly Virak, Sorpasirth Souphathay, Dethvongphanh Maneelay, Norcharoen Boualay, Htalongsengchan Bousanit, Fucharoen Goonnapa, Fucharoen Supan, Schelp Frank P, Saowakontha Sastri, Sanchaisuriya Pattara
Southeast Asian J Trop Med Public Health. 2016 Sep;47(5):1040-7.
Screening for thalassemia carriers should not only be conducted in middle-income countries but also can be possible in low-middle income countries, through cooperation of experienced professionals from middle income countries. We describe a collaborating model between two close neighboring countries in establishing such a screening program for thalassemia. After training and setting up of facilities, a total of 152 out of 187 hospital staff were screened as a pilot activity to encourage community participation. Referring system for sending blood samples to a reference center in Thailand was also established. Among 152 health staff, 12.5% α0-thal, 2% β-thal and 13% Hb E carriers were found. Applying thalassemia screening to 411 pregnant women and 71 spouses, 5 couples at risk of bearing a child of thalassemia disease were identified. The thalassemia screening program has a sensitivity of 99.5%, specificity of 77%, positive predictive value of 73%, and negative predictive value of 99.5%. Thus, it is possible to operate a thalassemia screening program with acceptable performance in a low-middle income country (Lao People’s Democratic Republic) with the cooperation of a referral center located within close proximity in a middle income country (Thailand).
地中海贫血携带者筛查不仅应在中等收入国家开展，通过中等收入国家经验丰富的专业人员合作，在中低收入国家也有可能实现。我们描述了两个相邻国家在建立此类地中海贫血筛查项目时的合作模式。在培训和设施搭建后，作为鼓励社区参与的试点活动，对187名医院工作人员中的152人进行了筛查。还建立了将血样送往泰国参考中心的转诊系统。在152名医护人员中，发现12.5%为α0地中海贫血携带者，2%为β地中海贫血携带者，13%为血红蛋白E携带者。对411名孕妇和71名配偶进行地中海贫血筛查，确定了5对有生育地中海贫血患儿风险的夫妇。该地中海贫血筛查项目的灵敏度为99.5%，特异度为77%，阳性预测值为73%，阴性预测值为99.5%。因此，在中等收入国家（泰国）附近的转诊中心合作下，在中低收入国家（老挝人民民主共和国）开展具有可接受性能的地中海贫血筛查项目是可行的。
