The Impact of Mean Corpuscular Volume in Identifying Thalassemia Trait Through the Premarital Screening Program in Northern Jordan

Objectives: To study the significance of Mean Corpuscular Volume (MCV) measurement in the identification of thalassemia trait during a premarital screening program in Irbid in north of Jordan. Patients and Methods: All couples applied for marriage procedures in Irbid city were screened over a one year period. When MCV results were less than 80 fL in both of them, then hemoglobin electrophoresis was performed to both to confirm the diagnosis of thalassemia trait. The subjects were considered to have the beta-thalassaemia trait if they had a hemoglobin A2 level of more than 3.2% or a hemoglobin F level of more than 2%. Results: During the study period, premarital screening of hemoglobinopathies was evaluated retrospectively in 1752 subjects (876 couples). MCV less than 80 fL was detected in 568 (32.4%) subjects (284 couples) for whom Hb electrophoresis was further measured. HbA2 higher than 3.2%was found in 110 of them, 47 (16.4%) female subjects and 63 (22.3%) male subjects. The percentage of high HbA2 from the total accounts of subjects evaluated in premarital screening was calculated to be (0.062) and for those with low MCV was (19.4%) with a 95% confidence interval value 0.736 (o.449-1.034). Fourteen couples both of them have high HbA2. HbF was found to be high in another 26 (4.5%) subjects from both sexes, 5 couples both of them have high HbF, and that HbS and HbC were 8 (1.4%) and 2(0.4%), respectively. From this study, we concluded that the measurement of MCV alone is an effective minary premarital screening tool to identify possible thalassemia trait. For those with possible ait, Hb electrophoresis will identify definite cases of thalassemia trait.