A Cost Utility Analysis of the Right Method for Screening Hemoglobin E among Thai Pregnant women
Viroj Wiwanitkit
Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, 10330, Bangkok, Thailand. E-mail: wviroj@yahoo.com
บทคัดย่อ
Background: Inherited hemoglobin disorders are an important problem in many developing countries including Thailand. Of the several inherited hemoglobindisorders, hemoglobin E (HbE) (beta 26, GAG-AAG, Glu-Lys) is the most common hemoglobinopathy in Thailand. Presently, screening to identify carriers of hemoglobin disorders among pregnant subjects is an interesting topic in antenatal care in Thailand. Of late, many trials have been conducted to identify the right screening methods for the detection of hemoglobin disorders among Thai pregnant women. The common screening methods include red blood cell (RBC) index determination, application of mathematical model and hemoglobin electrophoresis.  Methods: Here, the author presents an evaluation of the cost utility of those tests inmedical practice in Thailand. The cost/utility of hemoglobin electrophoresis is the highest followed by RBC index determination, application of mathematical model and DCIP test.  Results: Here, it can be shown that the cost per accurate diagnosis for DCIP is the leastexpensive.  Conclusion: It is interesting to note that DCIP also posed high sensitivity in the screening for HbE disorder. Therefore, this test is the best method for screening the population, particularly pregnant women, to identify carriers of hemoglobin disorders. It should berecommended as part of antenatal care in Thailand as well as its neighbouring countries which have a similar high rate of HbE disorder.
ที่มา
Archives of Gynecology and Obstetrics ปี 2549, May ปีที่: 274 ฉบับที่ 2 หน้า 88-90