Skip to main content Skip to main navigation menu Skip to site footer

The compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening

  • Raja Iqbal Mulya Harahap ,
  • Delita Prihatni ,
  • Tiene Rostini ,


Background: Thalassemia is an autosomal recessive disease. It occurs due to abnormalities in hemoglobin synthesis, causes the imbalance of globin production. Identification of thalassemia’s carrier plays a role to prevent disease’s inheritance. Diagnostic approaches regarding anemia, especially in families are important because they are prone to inherit the disease. This study was aimed to know the compatibility of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices with hemoglobin electrophoresis in transfusion-dependent thalassemia patient’s family.

Methods: This was a cross sectional study by obtaining routine hematology and hemoglobin electrophoresis from thalassemia major patient’s family screening. The data then analyzed with Kappa and chi-square to get the compatibility and significance between variables. Data were analyzed using Microsoft Excel and SPSS version 17 for Windows

Results: From 99 subjects, most of them are women aged 18-55 years. Beta thalassemia trait based on Mentzer, England & Fraser, Srivastava, and Shine & Lal was in 46,5%, 55,6%, 55,6%, and 54,5% research subjects respectively. Hemoglobin electrophoresis results showed that beta thalassemia trait was in 47.5% subjects. Kappa test showed good and significant compatibility result of hemoglobin electrophoresis with Mentzer (k=0,663,p= 0,0001) and England & Fraser (k=0,636,p=0,002)  indices, also moderate and significant compatibility for Srivastava (k=0,558,p=0,018) and Shine & Lal indices(r=0,527,p= 0,015) with hemoglobin electrophoresis

Conclusions: There were compatible and significant results between Mentzer and England & Fraser with hemoglobin electrophoresis. Meanwhile, Srivastava and Shine & Lal indices have medium compatibility so that they can be used as an initial screening for beta thalassemia trait in transfusion-dependent thalassemia patient’s family


  1. Majeed T, Akhter MA, Nayyar U, Riaz MS, Mannan J. Frequency of β-thalassaemia trait in families of thalassaemia major patients, Lahore. J Ayub Med Coll Abbottabad. 2013; 25(3-4):58-60.
  2. Yunanda Y. Talasemia. Jurnal Repositori Universitas Sumatera Utara. 2008;1-30.
  3. Dwi Sarwani Sri Rejeki et al. Studi Epidemiologi Deskriptif Talasemia. Jurnal Kesehatan Masyarakat Indonesia. 2012; 7(3):139-45.
  4. Bandeira FMGC, Santos MNN, Bezerra MAC, Gomes YM, Araujo AS, Braga MC et al. Family screening for HBB*S gene and detection of new cases of sickle cell trait in Northeastern Brazil. Rev Saude Publica. 2008;48(2):1-7.
  5. Gibson F, Mason K, Serjeant B, Kulozik A, Happich M, Tolle G, et al. Screening for the beta thalassaemia traits: hazards among populations of West Africa. J Community Genet. 2012; 3(1):13–18
  6. Meshram PM, Kokandakar HR, Bindu RS. Study of blood indices and high performance liquid chromatography in differentiation beta thalassaemia trait and iron deficiency anemia. International Journal of Research in Medical Sciences. 2017; 5(11):4728-2736.
  7. Aziz Batebi, Pourreza A, Esmailian R. Discrimination of beta-thalassemia minor and iron deficiency anemia by screening test for red blood cell indices. Turk J Med Sci. 2012;42(2):275-80.
  8. Foundation CsA. Thalassaemia Trait. New York: Cooley's Foundation; 2008.
  9. Fatima N, Amjad S, Shah R, Hameed A. Frequency of iron deficiency anemia in first degree relatives od beta thalassaemia major patients. Journal of Nigerian Hematology. 2010; 4(1):40-42
  10. Rahadiyanto KY. Perbandingan beberapa indeks eritrosit untuk penapisan beta thalassaemia minor dan anemia defisiensi besi. Journal Universitas Sriwijaya. 2013:1-7.
  11. Piplani S, Madan M, Mannan R, Manjari M, Singh T, Lalit M. Evaluation of various discrimination indices in differentiating iron deficiency anemia and beta thalassaemia trait: a practical low cost solution. Asia Pasific Laboratory. 2016; 3(6 Suppl):551-559
  12. Kumar A1, Saha D1, Kini J, Murali N, Chakraborti S, Adiga D. The role of discriminant functions in screening beta thalassaemia and iron deficienct anemia among laboratory samples. J Lab Physicians. 2017; 9(3):195-201
  13. Narchi H, Basak R. Comparison of erythrocyte indices to differentiate between iron deficiency and alpha thalassaemia in children with microcytosis and/or hypochromia. East Mediterr Health J. 2010; 16(9):966-71.
  14. Ullah Z, Khattak AA, Ali SA, Hussain J, Noor B, Bano R, Jan Mahsud MA. Evaluation of five discriminating indexes to distinguish beta-thalassemia trait drom iron deficiency anemia. J Pak Med Assoc. 2016; 66(12):1627-1631.
  15. Niazi M, Mohammad T, Raziq FE, Hameed A. Usefulness of Red Cell Indices in Differentiating Microcytic Hypochromic Anemias. Gomal Journal of Medical Sciences. 2010: 8(2):125-129

How to Cite

Harahap, R. I. M., Prihatni, D., & Rostini, T. (2019). The compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening. Bali Medical Journal, 8(2), 403–407.




Search Panel

Raja Iqbal Mulya Harahap
Google Scholar
BMJ Journal

Delita Prihatni
Google Scholar
BMJ Journal

Tiene Rostini
Google Scholar
BMJ Journal