Hemoglobinopathies and iron deficiency among Northeast-Thai blood donors deferred for low hemoglobin

While iron deficiency (ID) is well-known as the main reason for low hemoglobin (Hb) deferral among blood donors, the contribution of hemoglobinopathies (HgPs) has been overlooked. This study determines the prevalence of HgPs and ID among northeast (NE) Thai blood donors deferred for low Hb and investigates factors associated with ID. Participation included a total of 355 blood donors that were deferred for low Hb. A self-administered questionnaire was used to collect sociodemographic and health-related information. HgPs and ID were diagnosed following standard guidelines. The prevalence of HgPs and ID was 72.1% (95% CI = 67.1–76.7) and 31.0% (95% CI = 26.2–36.1), respectively. Of the HgP carriers, Hb E and its interaction with α-thalassemia were most common. All forms of HgPs and the use of iron supplement showed a reduction in the odds of having ID, as compared to the reference group. The lowest chance of having an ID was observed in individuals homozygous for Hb E with an adjusted OR (aOR) of 0.04 (95% CI = 0.005–0.31). The odds of having ID among females was 12.4 times (95% CI = 1.5-102.6) higher than males. The findings indicate that HgPs predominate over ID among NE-Thai blood donors deferred for low Hb, and carriers of HgPs are less likely to develop ID than non-HgPs.