Evaluation of WHO haemoglobin colour scale & palmar pallor for screening of anaemia among children (6-35 months) in rural Wardha, India.
OBJECTIVE
Anaemia is a public health problem in India, particularly in women and children. Clinical diagnosis by health workers may be inaccurate. It is therefore important to evaluate simple methods for diagnosis of anaemia in rural set up with no or minimal laboratory facilities. We carried out this study to evaluate the performance of haemoglobin colour scale and palmar pallor against filter paper cyanmethaemoglobin method as screening methods for anaemia in children 6-35 months of age.


METHODS
A total of 772 children between 6-35 months were studied from three primary health centres of Wardha district, central India, by house-to-house visit. The child was examined for presence of palmar pallor and haemoglobin estimated by haemoglobin colour scale (HCS) and filter paper cyanmethaemoglobin method independently by two persons.


RESULTS
Haemoglobin colour scale had sensitivity of 89 per cent and specificity of 97 per cent in detecting anaemia in children. Pallor had sensitivity of 73 per cent and specificity of 98 per cent. The predictive values were 99 per cent and 69 per cent for positive and negative HCS result. Similarly, the predictive values were 99 and 48 per cent for positive and negative pallor result. Correct diagnosis of anaemia was 34 and 0.1 times common if HCS test result was positive (Hb < 110.0 g/l) and negative (Hb > 110.0 g/l) for anaemia.


CONCLUSIONS
HCS fulfills the requirement of field test for screening of anaemia in resource poor country. It also has acceptable precision and accuracy and hence can be used in national anaemia control programmes.
Sinha
N
N
Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Sewagram, India.
Deshmukh
P R
PR
Garg
B S
BS
D000740:Anemia / Q000175:diagnosis* / Q000453:epidemiology; D002675:Child, Preschool; D003116:Color; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards* / Q000706:statistics & numerical data; D009017:Morbidity; D010167:Pallor / Q000175:diagnosis* / Q000453:epidemiology; D011320:Primary Health Care; D015203:Reproducibility of Results; D012424:Rural Population / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D014944:World Health Organization
D006454:Hemoglobins