Comparison of Red Cell Indices in Iron Deficiency Anemia and Beta Thalassemia Minor in Children Age 6 Months to 2 Years

Background: Iron deficiency anemia (IDA) and β-thalassemia trait (β-TT) are the most common microcytic hypochromic anemias in children. Distinguishing between these conditions is essential for accurate management and genetic counseling, especially in resource-limited settings where advanced diagnostic testing may not be readily available. Red cell indices provide a simple and cost-effective method for differentiating between red blood cells. Objective: To determine and compare mean red cell indices in children aged 6 months to 2 years with iron deficiency anemia and β-thalassemia minor. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Unit-C of Khyber Teaching Hospital, Peshawar, Pakistan. Duration of Study: 21-October-2024 to 21-April-2025. Methods: A total of 60 children aged 6 months to 2 years were enrolled, including 30 with IDA and 30 with β-TT. Children were classified as IDA if hemoglobin was <13 g/dL with serum ferritin <10 ng/mL, and as β-TT if hemoglobin was <13 g/dL with HbA2 >7%. Venous blood samples were analyzed for hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and red blood cell (RBC) count. Statistical analysis was performed using SPSS (version [insert]), with p < 0.05 considered significant. Results: The mean MCV was significantly higher in IDA (75.04 ± 2.06 fL) compared to β-TT (72.89 ± 1.77 fL; p < 0.0001). MCHC was lower in IDA (31.59 ± 1.49 g/dL) than in β-TT (34.44 ± 1.13 g/dL; p < 0.0001). RDW was markedly elevated in β-TT (19.39 ± 1.71%) compared to IDA (14.32 ± 1.64%; p < 0.0001). RBC counts were higher in β-TT (4.90 ± 0.98 ×10⁶/μL) compared to IDA (4.06 ± 0.62 ×10⁶/μL; p < 0.0001). Conclusion: Red cell indices, including MCV, MCHC, RDW, and RBC count, demonstrated significant differences between IDA and β-TT. These findings support their role as simple, reliable, and cost-effective discriminators in differentiating between the two conditions in pediatric populations.