Document Type : Letters to the Editor


Wiwanitkit House, Bangkhae, Bangkok, Thailand

Sir, the recent publication on Naked-Eye-Single-Tube-Osmotic- Fragility-Test (NESTROFT) for beta-thalassemia carrier detection s very interesting (1). Concluded that “NESTROFT appears to a valid test in rural setting with financial constraints (1).” We would like to share experience on this issue. Based on our experience, using NESTROFT along or combined with dichlorophenol-indolephenol (DCIP) tests is a good screening tool for detection beta-thalassemia carrier (2–4). Focusing on rural communities, it is approved cost effective (2). However, there are some issues on using NESTROFT to be noted. First, this test cannot successfully determine all kinds of thalassemia and hemoglobinopathy. Alpha-thalassemia cannot be successfully screened by this techinique (2–4). Adding of DCIP might help screen other hemoglobinopathies such as hemoglobin E and hemoglobin Constant Spring (2–4). Second, the quality control of the test is needed (5). This test seems to be simple and classifiable as a point-of-care testing. The quality control might be forgotten.

  1. Chakrabarti I, Sinha SK, Ghosh N, Goswami  BK. Beta-Thalassemia Carrier Detection by NESTROFT: An Answer in Rural Scenario? Iranian J Pathol 2012; 7(1):19–26.
  2. Wiwanitkit V. Using of osmotic fragility (OF) and dichlorophenol-indolephenol (DCIP) tests screening for antenatal clinic: appraisal of usefulness of the program in rural Thai communities. Rural Remote Health 2006;6(2):587.
  3. Wiwanitkit V, Suwansaksri J, Paritpokee N. Combined one-tube osmotic fragility (OF) test and dichlorophenol-indolphenol (DCIP) test screening for hemoglobin disorders, an experience in 213 Thai pregnant women. Clin Lab 2002;48(9-10):525-8.
  4. Wiwanitkit V. Combined osmotic fragility and dichlorophenol-indolphenol test for hemoglobin disorder screening in Thai pregnant subjects: an appraisal. Lab Hematol 2004;10(2):119-20.
  5. Chapple L, Harris A, Phelan L, Bain BJ. Reassessment of a simple chemical method using DCIP for screening for haemoglobin E. J Clin Pathol 2006;59(1):74-6.