Haemoglobin Electrophoresis Patterns and Their Clinical Interpretation in a Tertiary Healthcare Setting
Rayhan Chowdhury *
Department of Environmental Health and Wash, International Centre for Diarrhoeal Disease Research (ICDDRB), Bangladesh.
Hafizul Islam
Department of Transfusion Services, The Ohio State University- Wexner Medical Center, USA.
Al Imran Rimon
Department of Laboratory Medicine, Central Police Hospital, Dhaka, Bangladesh.
Md. Mahfuz Al Mubin
Department of Laboratory Medicine, Grameen Medical Services, Sylhet, Bangladesh.
Pronoy Kumer Sarker
Department of Laboratory Medicine, Popular Diagnostic Centre Limited, Dhaka, Bangladesh.
Sumon Halder
Department of Haematology, National Institute of Laboratory Medicine and Referral Centre, Dhaka, Bangladesh.
Md Samiul Bashir
Department of Laboratory Medicine, Institute of Health Technology, Kurigram, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Hemoglobinopathies and thalassemia’s are among the most common inherited disorders globally, particularly prevalent in South and Southeast Asia. In Bangladesh, conditions such as Hb E trait, Hb E disease, and beta thalassemia trait are increasingly recognised as significant contributors to anaemia and related health burdens. Haemoglobin electrophoresis remains the primary screening and diagnostic tool in resource-limited settings due to its affordability and ability to differentiate between haemoglobin variants.
Objective: The study aimed to analyse the prevalence, distribution, and clinical correlation of haemoglobin variants in a Bangladeshi population using haemoglobin electrophoresis and to explore associations with demographic and haematological parameters.
Methods: This descriptive cross-sectional study was conducted at the Bangladesh Diabetic Care Hospital, located in Dhaka, Bangladesh, on 215 patients referred for haemoglobin electrophoresis over a period of 10 months from February 2024 to November 2024. Data on age, sex, clinical history, family history, and comorbidities were collected. Complete blood count (CBC) and haemoglobin variant quantification (Hb A, A2, F, E, D, S, C) were performed. Statistical analysis included descriptive statistics and Pearson correlation to examine relationships between haemoglobin fractions and red cell indices (MCV, MCH), with significance set at p < 0.05.
Results: Of the 215 patients, 66.05% showed normal haemoglobin patterns. Hb E trait (14.42%) and beta thalassemia trait (7.44%) were the most common abnormalities. Hb E disease was observed in 6.51%, while low Hb A2 and other rare variants accounted for the remainder. Significant negative correlations were found between Hb A2 and MCV (r = –0.62, p < 0.001), and Hb F and MCH (r = –0.39, p = 0.006). Hb E correlated positively with Hb A2 (r = 0.78, p < 0.001). Family history was positive in 40.9% of patients, with the highest rates among beta thalassemia trait cases (81.3%).
Conclusion: This study provides valuable insights into the prevalence and distribution of hemoglobinopathies and thalassemia’s in a Bangladeshi population. Haemoglobin E and beta thalassemia traits are the most prevalent hemoglobinopathies in the studied population. Strong correlations between haemoglobin variants and red cell indices affirm the diagnostic utility of electrophoresis. Early detection through screening, particularly in at-risk populations, could lead to better management and reduced morbidity from these genetic disorders.
Keywords: Haemoglobin electrophoresis, beta thalassemia, Hb E trait, hemoglobinopathies, Bangladesh population