title: Using clinical signs to diagnose anaemia in African children.
abstract: 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.
authors.affiliation: Epidemiology Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: S P
authors.initials: SP
authors.lastname: Luby
authors.forename: P N
authors.initials: PN
authors.lastname: Kazembe
authors.forename: S C
authors.initials: SC
authors.lastname: Redd
authors.forename: C
authors.initials: C
authors.lastname: Ziba
authors.forename: O C
authors.initials: OC
authors.lastname: Nwanyanwu
authors.forename: A W
authors.initials: AW
authors.lastname: Hightower
authors.forename: C
authors.initials: C
authors.lastname: Franco
authors.forename: L
authors.initials: L
authors.lastname: Chitsulo
authors.forename: J J
authors.initials: JJ
authors.lastname: Wirima
authors.forename: M A
authors.initials: MA
authors.lastname: Olivar
mesh_terms: 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