Premarital Screening for Thalassemia Among Young Adults: A Study in Zabol, Sistan and Baluchistan Province of Iran

Introduction: There is a high prevalence of hemoglobinopathies, including thalassemia, in Sistan and Baluchistan province of Iran. It is important to appropriately screen young adults to control the birth of new cases of thalassemia. In many less-equipped centers, this practice only relies on cell blood count. This study investigated the hematological parameters of young adults referring to the Central Laboratory of Sistan, Zabol, for premarital screening for thalassemia. Methods: This was a descriptive cross-sectional study conducted in Zabol, Sistan and Baluchistan province of Iran from August 2020 to August 2021. Complete blood count (CBC) parameters of 2926 young adults were collected using a Sysmex KX-21 device and were compared with available reference intervals according to the Clinical and Laboratory Standard Institute. Results: The means of women’s and men’s age were 38.84±16.32 and 36.64±14.14 years, respectively. The average values for each parameter in the studied population were red blood cell (RBC) (4.78±0.55), hemoglobin (13.19±2.46 g/dL), hematocrit (40.11±3.57%), mean corpuscular volume (MCV) (85.16±28.33), neutrophil (52.12±9.98), lymphocyte (37.84±9.03), mixed leukocytes (10.00±3.51), platelets (244.02±62.32). The mean values of hemoglobin (14.48±5.17 vs. 12.69±1.39 g/dL), hematocrit (43.01±3.89 vs. 38.97±3.45%), serum ferritin (115.4±74.3 vs. 69.20±12.36 g/dL), total iron-binding capacity (316.84±1.38 vs. 320.95±41.01, P=0.01), and serum iron (85.05±28.51 vs. 76.25±28.22, P=0.02) were significantly lower in women than in men. Out of 2,926 people who entered this study, 195 (6.66%) were suspected of having thalassemia because of their low MCV (71.61±7.33 fL) and mean corpuscular hemoglobin (MCH) (23.67±2.66 pg). Conclusion: The relatively low hemoglobin in females referring for premarital screening for thalassemia awakens healthcare experts to carefully examine these cases for the possibility of thalassemia minor after excluding other common possible reasons such as iron deficiency anemia using iron studies and hemoglobin electrophoresis.