Early detection of anemia among school children using the World Health Organization Hemoglobin Color Scale 2006
Keywords:
early detection, anemia, children, Hemoglobin Color Scale
Abstract
Background The high prevalence of anemic children in Indonesiais caused by the high incidence of diseases caused by parasitic
infection such as malaria as well as iron deficiency. Early detection
is needed for early intervention in order to allow optimal growth
and development. A simple, economic, and practical tool for
early detection of anaemic children is needed. The WHO
recommended a Hemoglobin Color Scale as a suitable tool for
the detection of anemia.
Objective To assess the sensitivity, specificity, and predictive
values of the WHO Hemoglobin Color Scale for early detection
of anemic children.
Methods A cross sectional diagnostic test was conducted in
elementary school age children. Samples consisting of two drops of
venous blood on paper were assessed by two observers (pediatrician
& paramedic) using the Hemoglobin Color Scale to visually
determine the level of hemoglobin. In addition, the hemoglobin
level was also measured using a Hematology Analyzer to allow the
visual test results to be compared to the results obtained using the
gold standard of analysis. Agreement between these two methods
of analysis was examined using the Cohen's kappa.
Results Hemoglobin levels < 11.5 g/dL were detected in 15 of
124 (12%) elementary school children. The sensitivity, specificity,
positive and negative predictive values when using the Hemoglobin
Color Scale were 93%, 100%, 100% and 99% respectively for the
first observer and 100%,99%,93%, and 100% respectively for the
second observer. The Cohen's Kappa value was 0. 76.
Conclusion The WHO Hemoglobin Color Scale 2006 could
be used as an early detection method for anemia in children.
References
1. Martin S, Logan S, Gilbert R. Iron therapy for improving
psychomotor development and cognitive function in children
under age of three with iron deficiency. [Cochrane review]
In: The Cochrane Database of Systematic Reviews, issue 2,
2001, Oxford: Update Software.
2. Warton BA. Iron Deficiency in Children: Detection and
prevention. British Journal of Hematology.1999; 106:270-
280.
3. Iron Deficiency anemia: Assessment, prevention and control:
a guide for programme managers. WHO 2001. p 1-68.
4. Zlotkin SH, Christofides AL, Ziauddin H, Schauer CS,
Tondeur MC and Sharieff W. Controlling iron deficiency
anemia through the use of hone-fortified complementary
foods. Indian Journal of Pediatrics. 2004; 71:1015-9.
5. Anemia gizi anak salah satu masalah gizi utama di Indonesia.
Badan Penelitian dan Pengembangan Kesehatan Departemen
Kesehatan RI 2005.
6. Review of the Hemoglobin Color Scale: report of an informal
consultation. WHO 2004. p 1-83.
7. Kim AL, Kumbu M, Anna M. Van Eijk, Peterson E,
Odhiambo F, Williamson J, et al. Evaluation of the WHO
Hemoglobin Color Scale for diagnosis of anemia in children
and pregnant women as used by primary health care nurses
and community health workers in western Kenya. Tropical
Medicine&International Health 2006; 11:1679-85.
8. Lara AM, Mundy C, Kandulu J, Chisuwo L dan Bates I.
Evaluation and costs of different hemoglobin methods for
use in district hospital in Malawi. J Clin Pathol. 2005; 58;56-
60.
9. Lewis SM. Looking backwards to the future: the WHO
hemoglobin Color Scale. Turk J Haematology.2002; 19:185-
189.
10. Ingram CF and Lewis SM. Clinical use of WHO hemoglobin
color scale: validation and critique. Journal Clin Pathol. 2000;
53:933-93 7.
11. Montressor A, Albonico M, Khalfan N, Stoltzfus, RJ, Tielsch
JM, Chwaya HM, et al. Field trial of a hemoglobin color scale:
an effective too to detect anemia in preschool children. Trop
Med Internat Hlth. 2000;5: 129-133.
12. Munster M, Lewis SM, Erasmus LK, and Mendelow BV Field
evaluation of a novel hemoglobin measuring device designed
for use in a rural setting. S Africa Med J. 1997; 87:1522-6.
13. Paddle JJ. Evaluation of hemoglobin color scale and
comparison with the HemoCue hemoglobin assay. Bull
WHO. 2002;80.
14. Stott GJ, Lewis SM, Wynn KJ. An inexpensive and reliable
new hemoglobin color scale for assesing anemia. J Clin Pathol.
1998;51:21-4.
15. Leal LP dan Osorio MM. Diagnostic accuracy comparison
between clinical sign and hemoglobin color scale as screening
methods in the diagnosis of anemia in children. Rev Bras
Saude Matern Infant. Recife, 6:183-189, abr./jun., 2006.
psychomotor development and cognitive function in children
under age of three with iron deficiency. [Cochrane review]
In: The Cochrane Database of Systematic Reviews, issue 2,
2001, Oxford: Update Software.
2. Warton BA. Iron Deficiency in Children: Detection and
prevention. British Journal of Hematology.1999; 106:270-
280.
3. Iron Deficiency anemia: Assessment, prevention and control:
a guide for programme managers. WHO 2001. p 1-68.
4. Zlotkin SH, Christofides AL, Ziauddin H, Schauer CS,
Tondeur MC and Sharieff W. Controlling iron deficiency
anemia through the use of hone-fortified complementary
foods. Indian Journal of Pediatrics. 2004; 71:1015-9.
5. Anemia gizi anak salah satu masalah gizi utama di Indonesia.
Badan Penelitian dan Pengembangan Kesehatan Departemen
Kesehatan RI 2005.
6. Review of the Hemoglobin Color Scale: report of an informal
consultation. WHO 2004. p 1-83.
7. Kim AL, Kumbu M, Anna M. Van Eijk, Peterson E,
Odhiambo F, Williamson J, et al. Evaluation of the WHO
Hemoglobin Color Scale for diagnosis of anemia in children
and pregnant women as used by primary health care nurses
and community health workers in western Kenya. Tropical
Medicine&International Health 2006; 11:1679-85.
8. Lara AM, Mundy C, Kandulu J, Chisuwo L dan Bates I.
Evaluation and costs of different hemoglobin methods for
use in district hospital in Malawi. J Clin Pathol. 2005; 58;56-
60.
9. Lewis SM. Looking backwards to the future: the WHO
hemoglobin Color Scale. Turk J Haematology.2002; 19:185-
189.
10. Ingram CF and Lewis SM. Clinical use of WHO hemoglobin
color scale: validation and critique. Journal Clin Pathol. 2000;
53:933-93 7.
11. Montressor A, Albonico M, Khalfan N, Stoltzfus, RJ, Tielsch
JM, Chwaya HM, et al. Field trial of a hemoglobin color scale:
an effective too to detect anemia in preschool children. Trop
Med Internat Hlth. 2000;5: 129-133.
12. Munster M, Lewis SM, Erasmus LK, and Mendelow BV Field
evaluation of a novel hemoglobin measuring device designed
for use in a rural setting. S Africa Med J. 1997; 87:1522-6.
13. Paddle JJ. Evaluation of hemoglobin color scale and
comparison with the HemoCue hemoglobin assay. Bull
WHO. 2002;80.
14. Stott GJ, Lewis SM, Wynn KJ. An inexpensive and reliable
new hemoglobin color scale for assesing anemia. J Clin Pathol.
1998;51:21-4.
15. Leal LP dan Osorio MM. Diagnostic accuracy comparison
between clinical sign and hemoglobin color scale as screening
methods in the diagnosis of anemia in children. Rev Bras
Saude Matern Infant. Recife, 6:183-189, abr./jun., 2006.
Published
2009-07-01
How to Cite
1.
Rusmawatiningtyas D, Setyowireni D, Mulatsih S, Sutaryo S. Early detection of anemia among school children using the World Health Organization Hemoglobin Color Scale 2006. PI [Internet]. 1Jul.2009 [cited 22Nov.2024];49(3):135-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/541
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Received 2016-09-10
Accepted 2016-09-10
Published 2009-07-01
Accepted 2016-09-10
Published 2009-07-01
