Using clinical signs to diagnose anaemia in African children.
Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of the conjunctiva, tongue, palm or nail beds was 66% sensitive and 68% specific in distinguishing children with moderate a anaemia (haemoglobin concentration, 5-8 g/dl) and 93% sensitive and 57% specific in distinguishing those with severe anaemia (haemoglobin concentration, < 5 g/dl). Even without laboratory support, which is often unavailable in rural Africa, clinical findings can identify the majority of children with anaemia.
Luby
S P
SP
Epidemiology Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Kazembe
P N
PN
Redd
S C
SC
Ziba
C
C
Nwanyanwu
O C
OC
Hightower
A W
AW
Franco
C
C
Chitsulo
L
L
Wirima
J J
JJ
Olivar
M A
MA
D000740:Anemia / Q000097:blood / Q000175:diagnosis*; D002675:Child, Preschool; D006452:Hemoglobinometry; D006801:Humans; D007223:Infant; D008295:Malawi; D010167:Pallor; D010808:Physical Examination; D012494:Sampling Studies; D012680:Sensitivity and Specificity