RESUMO
BACKGROUND: Control of anemia can be achieved with early detection of pallor by parents at home. However, most parents lack the capacity to recognize pallor; thus most cases of anaemia are detected during hospital visit due to other symptoms. This study aimed to evaluate parental ability to detect pallor when aided with the anaemia screening tool. METHODS: In the study information on the symptoms of illness and parental knowledge on anaemia. Their ability to detect anaemia aided with the Home-Base anaemia-screen tool (HB-Anae) was compared to the healthcare providers' assessment of pallor. The haemoglobin estimation with the Hb-301 haemoglobinometer was used as the gold standard. RESULTS: None of the children in their previous illnesses had paleness as a complaint. Few (20.8%) parents knew what anaemia meant. Only 18.3% knew sites on the body where pallor can be detected. Many (55.1%; 304/552) surveyed children were anaemic (Hb<11g/dl) based on HB 301. Majority (88.8%; 270/304) of the parents aided with the HB-Anae were able to detect pallor on the children who were anaemic compared to 95.1% (289/304) detected by healthcare workers unaided, and the difference was not statistically significant (p=0.25). CONCLUSION: There was poor knowledge on anaemia among parents. The ability of parents to detect anaemia could be improved with the simple HB-Anae screen tool.
RESUMO
BACKGROUND: Anaemia in children has high mortality. We present the results of assessment of the accuracy of Haemoglobin Colour Scale in identifying anaemia compared with HemoCue assay. METHODS: The presence of anaemia in 524 children from four communities was screened using the Haemoglobin Colour Scale (HCS) and HemoCue assay. Independent healthcare providers that estimated the haemoglobin level using Hb-301 haemoglobinometer were different from those that read the colour scale. The sensitivity, specificity, positive predictive value, and negative predictive value were estimated. RESULTS: Of the 524 children surveyed, 44.5% (233/524), 50% (262/524), and 32.2% (168/524) were found to be anaemic using the HemoCue, HCS (p= 0.25), and clinical pallor (p=0.03) respectively. Using the HemoCue as standard, the sensitivity of the HCS and clinical pallor was 89.1% and 72.1%, respectively, and specificity 90.2% and 84.6%, respectively. 74.7 % of the colour scale result was within the 1.0g/dl of the HemoCue reading and 23 % was within 2.0g/dl. CONCLUSION: The HCS can improve the ability to detect anaemia especially where the use of the HemoCue is not feasible as in the resource poor countries. However, every case of anaemia requires further investigation to determine the underlying causes.
RESUMO
BACKGROUND: Clinicians rely on clinical detection of pallor to diagnose anaemia. This makes it important to evaluate the effect of different skin complexions on the accuracy of the pallor in diagnosing anaemia in children. METHODS: Clinicians conducted blind-independent physical examination, and their reports were compared with HemoCue 301 haemoglobin estimated with. The sensitivity and specificity were calculated. RESULTS: A total of 573 children were reviewed by 27 healthcare workers. The prevalence of anaemia was high. The highest prevalence was among children between the age of 4 and 12 months (urban 63.4% and rural 69.2%). Anaemia was detected better among dark-skinned children. Conjunctivae and palm pallor had the highest sensitivity (78.6% and 69.2%, respectively). DISCUSSION: Clinical pallor is a good screening assessment for anaemia but not diagnostic. Its sensitivity and specificity vary among different sites and skin complexions. Thus combining findings at any of the sites can improve detection of anaemia in children.
