Efficiency of premarital screening of beta-thalassemia trait using MCH rather than MCV in the population of Fars Province, Iran

Iran is a country with high prevalence of about 5-10% of beta-thalassemia trait. The prevalence of Cooly's anemia has declined from 11.6 in 10000 population to 7.2 in 10000 in a five-year period due to screening program of beta-thalassemia trait before marriage. This study was conducted to compare the sensitivity of mean corpuscular hemoglobin (MCH) < 27 pg and mean corpuscular volume (MCV) < 80 fl as a screening test in first step of screening of beta-thalassemia trait. From 2449 couples (4898 cases) participating in the premarital screening to our clinic, 902 cases with either MCH < 27 pg, MCV < 80 fl, anemia, pallor or family history of beta-thalassemia were enrolled in the study. MCV, MCH as well as Hb A2 were measured in all cases. MCH and MCV had sensitivities of 98.5% and 97.6% for the diagnosis of beta-thalassemia trait, respectively. A false negative value of MCH is about 1% lower than that of MCV. MCH is a more sensitive screening test for detecting beta-thalassemia minor before marriage.