Screening of Medical Students for Thalassemia and Other Hemoglobinopathies by High-Performance Liquid Chromatography for Primary Prevention in Ahmedabad City: A Cross-Sectional Study

Abstract

Background: In India, carrier detection for thalassemia and structural hemoglobin variants is a practicable primary-prevention strategy, where endogamy, regional clustering, and asymptomatic carrier states sustain the birth of affected children. Medical students are an important screening cohort because they are young adults, future reproductive decision-makers, and potential health educators. Screening them can convert laboratory diagnosis into durable community awareness and promote informed reproductive choices.

Methods: Cross-sectional design, this research was carried out in the Department of Pathology, GMERS Medical College and Civil Hospital, Sola, Ahmedabad, from July 2019 to June 2021. The participants were undergraduate and postgraduate medical students aged between 18–35 years who volunteered for screening. EDTA blood samples were analysed for complete blood count, peripheral smear morphology and hemoglobin fractions using Bio-Rad VARIANT high-performance liquid chromatography, beta-thalassemia short programme.

Results: Among 256 students, the mean age was 21.4 +/- 3.4 years and 135 (52.7%) were women. HPLC showed a normal hemoglobin pattern in 246 students (96.1%). Ten students (3.9%; 95% CI, 2.1-7.0) had a carrier pattern: beta-thalassemia trait in six (2.3%; 95% CI, 1.1-5.0), sickle cell trait in two (0.8%) and Hb D trait in two (0.8%). Compared with students with a normal pattern, abnormal HPLC profiles showed higher RBC count, lower MCV, lower MCH and higher RDW. Beta-thalassemia trait had mean HbA2 of 5.0 +/- 0.5%, mean MCV of 60.7 +/- 14.8 fL and mean RBC count of 5.5 +/- 0.5 million/cumm.

Conclusion: HPLC-based screening identified a clinically silent but preventable hemoglobinopathy carrier burden in medical students. Integrating CBC, smear review, HPLC reporting and genetic counselling in medical colleges can strengthen premarital and preconception prevention pathways in Ahmedabad.