Vaccination Status in Children with Chronic Diseases: Are They Up-to-Date for Mandatory and Specific Vaccines?

OBJECTIVE: The aim of this study is to investigate the immunization coverage for mandatory and specific vaccines in a group of children with chronic diseases. MATERIALS AND METHODS: Children with chronic diseases aged 6 months to 18 years who were followed up by outpatient subspecialty clinics of a tertiary hospital were enrolled. Children who were up-to-date and who were under-vaccinated were compared with respect to demographic characteristics, parental educational status, healthcare providers' attitudes toward vaccination, age at the time of diagnosis, and duration of follow-up. RESULTS: A total of 366 patients with variable chronic diseases were enrolled. Of these, 84.7% were up-to-date for the mandatory vaccines. This rate was 99.5% for the primary series of diphtheria-tetanus-acellular pertussis and 98.9% for the first dose of measles-mumps-rubella vaccines. Vaccination coverage for specific vaccines was low (13.9% for influenza and 55% for conjugated pneumococcal vaccine). Being older at the time of diagnosis increased the likelihood of being up-to-date for mandatory vaccines by 1.1 times, while being followed up from multiple subspecialty outpatient clinics and attendance to private doctors' clinics for vaccination increased the likelihood of being up-to-date for specific vaccines by 19.1 and 6.4 times, respectively. CONCLUSION: In this study, immunization coverage for mandatory vaccines was comparable to that of the general population. However, vaccination coverage was low for specific vaccines. Therefore, efforts of prioritization of pediatric immunizations and raising awareness among healthcare providers about the impact of medical recommendations for specific vaccines among children with chronic diseases can help to improve vaccination rates.

The Silent Victims of the Pandemic: Children During the Coronavirus Disease 2019 Crisis.

The coronavirus disease-19 pandemic has adversely affected children's health since its inception. Apart from the mortality and morbidity due to infection, child health monitoring, vaccination, and nutrition programs, especially in newborns and young children, have been disrupted. Measures such as school closures and curfews to prevent the spread of infection brought along many physical and mental health problems by causing disruption of education, social isolation, and closure of children at home. The possible long-term effects of the delayed implementation of the Sustainable Development Goals in Health have also deeply affected children, who are the most vulnerable victims of the coronavirus disease-19 pandemic.

Young children's sleep patterns and problems in paediatric primary healthcare settings: a multicentre cross-sectional study from a nationally representative sample.

Studies describing paediatric sleep patterns are needed by taking culture into consideration. The aim of this study was to identify parent-reported sleep-wake patterns in young children and explore possible factors influencing sleep problems. The mothers of 2,434 young children enrolled from well-child outpatient clinics in Turkey completed an online survey including sociodemographic variables, Brief Infant Sleep Questionnaire, Edinburgh Postnatal Depression Scale and Generalised Anxiety Disorder scales. Overall, young children in Turkey go to bed late (10:00 p.m.), awaken twice per night for 30 min, and obtain 11.5 h of total sleep, showing no sex-specific differences. Distinct night-time sleep patterns emerged after 18 months of age. Importantly, although currently breastfed healthy children were 3.8-times less likely to sleep through the night, total sleep duration and exclusive breastfeeding duration were higher in children who were not sleeping through the night. Overall, bedsharing was identified in 11.5%, and only room sharing was reported in 52.9%. Parental perception of a child's sleep as problematic was 35.8%. Mothers with higher educational attainment were more likely to perceive their children's sleep as a problem. Maternal depressive and anxious symptoms and a history of excessive infant crying were the determinants predicting the likelihood of both parent-perceived sleep problems and poor sleepers. The present analysis of sleep structure in infancy and toddlerhood provides reference data for well-child visits. These findings highlight the importance of considering maternal anxiety, depression and behaviour management techniques to cope with fussy infants in addressing childhood behavioural sleep problems.

The Effect of Vitamin D Prophylaxis on 25-OH Vitamin D Levels in Children.

BACKGROUND: Vitamin D deficiency is a major public health problem. The aim of our study was to determine serum 25-hydroxyvitamin D levels among healthy children aged 3-36 months in a setting where vitamin D prophylaxis is a national policy for infants during the first year of life and among pregnant women. METHODS: A total of 190 healthy children with a mean age of 15.9 ± 10.4 months were prospectively enrolled. RESULTS: The mean 25-hydroxyvitamin D level of children was 38.1 ± 16.2 ng/mL. 25 Hydroxyvitamin D level was ≥20 ng/mL in 87.4% of children while it was between 12 and 19 ng/mL in 10.5% and <12 ng/mL in 2.1% of the children. Children who were on vitamin D prophylaxis were found to have significantly higher 25-hydroxyvitamin D levels than those who were not on prophylaxis (41.6 ± 17.6 vs 33.6 ± 13.1 ng/mL; P = .001). None of the children >1 year of age who were on prophylaxis had 25 hydroxyvitamin D levels <20 ng/mL. No significant difference in 25-hydroxyvitamin D levels was found between children who were receiving different vitamin D doses (400 IU vs >400 IU). Analysis of covariance revealed that vitamin D prophylaxis and vitamin D supplementation of the mother during lactation had significant effects on 25-hydroxyvitamin D levels (P = .034 and P = .009, respectively). CONCLUSION: Although vitamin D prophylaxis at a dose of 400 IU seems to be sufficient to prevent vitamin D deficiency, we suggest that continuing vitamin D supplementation beyond 1 year of age with supplementation of pregnant and especially lactating mothers could have an impact on a replete vitamin D status among infants.

Determining Factors That Influence Nurses' Perceptions of Quality Implementations Conducted in Hospitals in Turkey.

BACKGROUND: Quality management program implementations in health services are team endeavors that involve all health service personnel. Because they are direct providers of care, nurses are best able to evaluate the influence of quality management program implementations on the health services and quality of care provided by hospitals. PURPOSE: The aim of this study was to develop an instrument to determine how nurses perceive the implementation of quality management programs in hospitals. Furthermore, the nurses' perceptions of the influence of these implementations on the quality of patient care and their job satisfaction were examined. METHODS: A descriptive, comparative, cross-sectional online survey was conducted using a convenience sample (N = 388) of practicing nurses working at public and university hospitals where quality management programs were implemented. Nurses' perceptions of the implementations were analyzed using confirmatory factor analysis, whereas the influence of nurses' perceptions of quality management implementations on patient care and job satisfaction was measured using structural equation modeling approaches. RESULTS: This study revealed that the instrument is valid and reliable for the measurement of participant perceptions of quality management program implementations. Nurses' perceptions were generally negative, and they exhibited negative attitudes toward the implementation of quality management in the institutions where they work. However, the quality management program implementations had little influence on perceptions of the quality of patient care. Participant job satisfaction was lower than average, and the quality management program implementations conducted in the hospitals negatively affected job satisfaction. On the other hand, participants who worked at university hospitals perceived quality management program implementations more affirmatively; patient care quality and job satisfaction were viewed more positively as well. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Because nurses do not participate effectively in quality management program implementations, they perceive these efforts as unnecessary and the responsibility of the quality control department. It is very important to ensure that all care-service providers participate to effectively implement quality management programs in hospitals and to encourage the adoption of a culture of patient safety in all institutions.

Comparison of Different Iron Preparations in the Prophylaxis of Iron-deficiency Anemia.

We compared the efficacy of ferrous sulfate (divalent) and ferric polymaltose (trivalent) compounds for the prophylaxis of iron-deficiency anemia (IDA). Study infants included exclusively breast milk-fed term infants. Subjects were divided randomly into 2 groups at 4 months of age and group 1 (n=56) received divalent and group 2 (n=56) received trivalent iron (Fe) preparation at a dose of 2 mg/kg/d for 5 months. At 9 months of age, after a 5-month prophylaxis, a significant increase was observed in hemoglobin (Hb), hematocrit, serum Fe levels, and transferrin saturation in both groups. However, group 1 had significantly higher Hb, hematocrit, mean corpuscular volume, Fe, and transferrin saturation than group 2 (11.7±0.6 g/dL, 34.6%±1.7%, 76.2±2.9 fL, 55.5±1.8 mcg, 20.8±3.9 g/L, respectively in group 1 vs. 11.3±0.5 g/dL, 33.5%±1.5%, 74.7±3.2 fL, 42.5±1.8 mcg, 14.1±7.5 g/L, respectively in group 2). No significant difference was found in ferritin values between the groups. Fe deficiency was found in 17 (30.3%) of the subjects in group 1, and 23 (41%) of subjects in group 2 whereas 5 (8.9%) subjects had IDA in group 1 and 12 (12%) in group 2 which were insignificant between groups. No significant difference was found with regard to side effects between 2 Fe preparations. Although divalent Fe therapy led to a higher Hb and serum Fe level, both ferrous and ferric Fe preparations were effective for prophylactic use in the prevention of Fe deficiency and IDA with comparable side effects.

Pneumococcal Nasopharyngeal Carriage in Young Healthy Children After Pneumococcal Conjugate Vaccine in Turkey.

AIMS: To determine the prevalence of nasopharyngeal carriage of Streptococcus pneumoniae in healthy children aged 0-6 years who were vaccinated with pneumococcal conjugate vaccine. METHODS: This cross-sectional study was conducted on 150 healthy Turkish children between 1 month and 6 years of age. Serotyping was performed and risk factors of carriage were evaluated. RESULTS: The overall carriage rate was 14%. Vaccine type serotypes were determined in 17 (12.6%) children who received full-dose PCV13 vaccine. The highest carriage rate was observed among children younger than 24 months (76.2%). In multivariate analysis, respiratory infection in recent months, age, attendance at a day-care center and antibiotic usage were not statistically significant risk factors for carriage. Overall, S. pneumoniae strains were considered as penicillin susceptible and antimicrobial resistance was limited. CONCLUSION: We observed a low rate of pneumococcal carriage in children after PCV13 implementation compared with that of children receiving PCV7. Although it was reduced, vaccine serotype colonization in PCV13-vaccinated children remains persistent.

Serum vitamin D levels during activation and remission periods of patients with juvenile idiopathic arthritis and familial Mediterranean fever.

The aim of this study was to determine the frequency of vitamin D deficiency and/or insufficiency in children with juvenile idiopathic arthritis (JIA) and familial Mediterranean fever (FMF) and to assess the relationship between vitamin D and disease activity. Sixty four patients with JIA, thirty six patients with FMF and one hundred healthy children were enrolled in this study. Vitamin D levels were measured during activation and remission periods in the patients with JIA and during attack and attack free periods in the patients with FMF. The mean vitamin D levels were found to be 18. 9±11 ng/ml and 18.6±9.2 ng/ml during activation and remission periods of disease, respectively, in the patients with JIA, 16±8.5 ng/ml and 13.1±6.4 ng/ml during attack and attack-free periods, respectively, in the patients with FMF and 26.7±10.5 ng/ml in the healthy children. There was no significant difference between vitamin D levels during activation and remission periods in the patients with JIA, whereas vitamin D levels during attack free periods were lower compared to attack periods in the patients with FMF. No significant relationship was found between disease activity and serum vitamin D levels. The vitamin D levels of the children with JIA and FMF were significantly lower compared to the healthy children. The frequency of vitamin D deficiency and insufficiency was considerably high among the patients with JIA and FMF.

Type of anesthesia affects neonatal wellbeing and frequency of transient tachypnea in elective cesarean sections.

OBJECTIVE: We aimed to assess whether the type of anesthesia in cesarean section (C/S) (spinal anesthesia, SA versus general anesthesia, GA) has an effect or not on umblical vein blood gas analysis and APGAR scores of term neonates and development of transient tachypnea of the newborn (TTN). METHODS: The data of 172 procedure (85, GA versus 87, SA) were collected retrospectively. Results of umblical vein blood gas analysis, APGAR scores at first and fifth minutes and presence of TTN from in-hospital files' of neonates were examined. RESULTS: Neonates in the SA group had significantly higher first and fifth minute APGAR scores (8, 7 versus 9, 2, p < 0.001 and 9, 3 versus 10, 2, p = 0.017, respectively). The pH value of umblical vein samples were higher (7.30 ± 0.05 versus 7.32 ± 0.05, p = 0.029) and pO2 and SaO2 levels were significantly lower in the SA group (34.8 ± 13.8 mmHg versus 27.6 ± 14.5 mmHg; p = 0.001 and 56.6% ± 18.7 versus 49.8% ± 21.4; p = 0.029, respectively) as compared to the GA group. Thirteen neonates in the GA group (15.3%) and five in the SA group (5.7%) were diagnosed as TTN (p = 0.048). CONCLUSION: In our study, considerable determinants of fetal wellbeing was stated to be higher in C/S performed under SA in comparison to GA. Furthermore, our findings favor SA for avoidance of TTN.

Hemoglobin cut-off values in healthy Turkish infants.

BACKGROUND: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality. This study was undertaken to determine the cut-off value of hemoglobin for infant anemia. METHODS: A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital. A total of 1484 healthy infants aged between 4 to 24 months were included in the study. The relationship of hemoglobin (Hb) levels with mother age, birth weight, weight gain rate, feeding, and gender was evaluated. RESULTS: The Hb levels were assessed in four age groups (4 months, 6 months, 9-12 months, and 15-24 months) and the cut-off values of Hb were determined. Hb cut-off values (5th percentile for age) were detected as 97 g/L and 93 g/L at 4 months and 6 months, respectively. In older infants, the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months, respectively. The two values were lower than the World Health Organization criteria for anemia, which could partly due to the lack of information on iron status in our population. However, this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries. Hb levels of females were higher in all age groups; however, a statistically significant difference was found in gender in only 6 month-old infants. No statistically significant difference was found among Hb levels, mother's age, birth weight, weight gain rate, and nutritional status. CONCLUSION: Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.

Job burnout in 159 anesthesiology trainees.

BACKGROUND: Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists. METHODS: Responses to perceived stress scale (PSS) and Maslach Burnout Inventory (MBI) were evaluated in 159 trainee anesthesiologists. RESULTS: In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization. CONCLUSIONS: Social factors such as gender and number of children affect the work life of our trainees.

A natural sorbent, Luffa cylindrica for the removal of a model basic dye.

In this work, application of Luffa cylindrica in malachite green (MG) removal from aqueous solution was studied in a batch system. The effect of contact time, pH and temperature on removal of malachite green was also investigated. By the time pH was increased from 3 to 5, the amount of sorbed malachite green also increased. Beyond the pH value of 5, the amount of sorbed malachite green remains constant. The fits of equilibrium sorption data to Langmuir, Freundlich and Dubinin-Radushkevich equations were investigated. Langmuir isotherm exhibited best fit with the experimental data. Monolayer sorption capacity increased with the increasing of temperature. Sorption kinetic was evaluated by pseudo-first-order, pseudo-second-order, Elovich rate equations and intraparticle diffusion models. It was inferred that sorption follows pseudo-second-order kinetic model. Thermodynamic parameters for sorption process were also found out. Spontaneous and endothermic nature of sorption was obtained due to negative value of free energy (DeltaG(o)) and positive value of enthalpy (DeltaH(o)) changes. FTIR analyses were also conducted to confirm the sorption of malachite green onto L. cylindrica.

Haemophilus influenzae type b antibodies in vaccinated and non-vaccinated children.

BACKGROUND: Invasive Haemophilus influenzae type b (Hib) infection has a high morbidity among young children, but the burden of disease and rate of Hib are different in different regions. The aim of the present study was to investigate the levels of Hib antibodies and the oropharyngeal Hib prevalence in young children. METHODS: One hundred-fifty nine healthy children aged 19-36 months of age were included in this cross-sectional study. Anti-polyribosylribitol phosphate (anti-PRP) antibody concentrations were measured using commercially available enzyme-linked immunosorbent assay (ELISA), and serotyping of isolated Hib strains was conducted by slide agglutination with specific antisera. RESULTS: Of the study participants, 57 (35.8%) were fully vaccinated (group 1A); 17 (10.7%) were incompletely vaccinated (group 1B), and 85 (53.5%) were non-vaccinated (group 2). Geometric mean titer (GMT) of anti-PRP antibody was 3.8 microg/mL, 2.2 microg/mL and 0.49 microg/mL in group 1A, group 1B and group 2, respectively. While all children in group 1 (n = 74) had seroprotective antibody concentrations (>/=0.15 microg /mL), of the children in group 2 (n = 85) 31.8% did not have seroprotective anti-PRP levels (P < 0.0001). A total of 68.2% in group 2 had natural immunity. Nineteen children (33.3%) in group 1, and 46 (54.1%) in group 2 had oropharyngeal Hib colonization (P = 0.0004). CONCLUSIONS: Hib conjugate vaccine is immunogenic and reduces Hib colonization. Each country should investigate the burden of Hib disease and the natural immunity in young children, and should determine antigenic dose, number of doses administered and dose intervals before deciding whether to introduce Hib conjugate vaccine in routine immunization programs.

Prosthetic and orthodontic rehabilitation of a patient with missing maxillary lateral incisors: a case report.

IPS Empress 2 materials can be used for fabrication of short-span fixed partial dentures in the anterior region as well as single crowns. This clinical report describes the prosthodontic treatment of a 16-year-old male patient with missing permanent maxillary left and right incisors with IPS Empress 2 fixed partial dentures following orthodontic treatment.

Is undernutrition a problem among Turkish school children?: Which factors have an influence on it?

Undernutrition is a frequent manifestation and an important health problem. The aim of this study was to analyse the variables of nutritional status among primary school children and to determine the risk factors associated with it. The study group was composed of 1576 students between 6 and 16 years of age. The prevalence of stunting, underweight, wasting were calculated according to WHO recommended cut-off points to define undernutrition. Chi-square tests, logistic regression analysis were used to investigate the relationship between the prevalence of undernutrition and the sociodemographic factors. The overall prevalence of stunting, underweight and wasting were found as 5.7, 4.6 and 1.0%, respectively. There were significant relationships between underweight and age, sex, number of family members, monthly family income. But, a significant correlation was found only between stunting and age. No correlation was found between wasting and sociodemographic factors. Undernutrition is still a common problem among primary school children in Istanbul. Identification of risk factors is essential for prevention of undernutrition.

Prevalence of anemia and the risk factors among schoolchildren in Istanbul.

Anemia is a frequent manifestation and an important health problem. The aim of this study was to found the prevalence of anemia among primary schoolchildren and determine the risk factors associated with anemia. The study group was composed of 1531 students between 6 and 16 years old from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire filled out by parents. For all students, a complete blood cell count detected by an automated cell counter and anemia prevalence was determined according to Dallman criteria. The overall prevalence of anemia was found to be 27.6 per cent. There was no significant relationship between the prevalence of anemia and the students' age, gender, parents' educational level and employment, and monthly family income by logistic regression analysis. Only the number of family members and malnutrition were risk factors for anemia. Today, anemia is a common problem among primary schoolchildren in Istanbul. Identification of the risk factors is essential for the prevention of anemia.

Enuresis: prevalence, risk factors and urinary pathology among school children in Istanbul, Turkey.

BACKGROUND: Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances. The aim of the present study was to establish the prevalence of enuresis among school children and determine the risk factors associated with this disorder. METHODS: A cross sectional population-based study was conducted in 1576 children. The pupils enrolled in the study were chosen randomly from 14 primary schools located in seven different regions of Istanbul. Data were collected via a questionnaire completed by parents. Enuretic children were invited to the pediatric nephrology outpatient clinic of Cerrahpasa Medical School, Istanbul, Turkey. A detailed history was taken, physical and ultrasonographic examinations, urinalysis and urine culture were performed. The relationship between the prevalence of enuresis and the patients' age, gender, region, the parental educational level and employment status, number of family members, and the family's monthly income were tested by means of chi(2 ) and logistic regression analysis. The comparison between the two enuretic groups (monosymptomatic nocturnal enuresis group vs diurnal enuresis only and diurnal-nocturnal enuresis group) regarding the sociodemographic factors were tested with the chi(2) test and P < 0.05 was accepted as statistically significant. RESULTS: The study group was composed of 1576 school children aged between 6 and 16 years. The overall prevalence of enuresis was 12.4%. When the chi(2) test was used, a significant relationship was found between the prevalence of enuresis and age, educational level of the father, the family's monthly income, and number of family members. However, when logistic regression analysis was applied, there was a statistically significant relationship only between enuresis, and age and number of family members. In the whole group, monosymptomatic enuresis nocturna was found to be more common in boys. When the two enuretic children groups (monosymptomatic nocturnal, diurnal only and nocturnal-diurnal enuretics) were compared with each other regarding gender, parental educational and employment status, and number of family members, statistically significant differences were found. Both maternal and the paternal low educational status were found to be associated with monosymptomatic enuresis nocturna. Likewise, monosymptomatic enuresis nocturna was found to be more common in the children of the unemployed mothers, while diurnal enuresis was more common in the children of unemployed fathers. Nocturnal enuresis was found to be associated with large families. No statistically significant difference was demonstrated between the two groups of enuretics regarding age and family income levels. The rate of urinary abnormalities in the whole group was 7.1%. CONCLUSIONS: Enuresis is a common problem among school children and associated urinary abnormalities are not uncommon. Identification of children at risk is an essential first step before choosing the individualized management for each enuretic child.

Prevalence and risk factors of iodine deficiency among schoolchildren.

The aim of this study was to demonstrate the prevalence of iodine deficiency among schoolchildren and the risk factors influencing it. One thousand five hundred and seventy-three schoolchildren were chosen from 14 schools in seven different regions in Istanbul. After all data relating to sociodemographic factors and the use of iodized salt were recorded, iodine contents of urine samples were determined by the Sandell Kolthoff reaction. Chi-squared and multiple regression analysis were used for the investigation of the correlation between iodine deficiency and risk factors. The prevalence of goitre (> or = 2 grade) was 1.9 per cent. The median urine iodine level was in the normal range (10.5 microg/dl). In 46.2 per cent of the students the urine iodine levels were below 10 microg/dl and 13.9 per cent of the students had urine iodine levels below 5 microg/dl. The prevalence of iodine deficiency was significantly higher in younger (< or = 10 years) children, in children with less educated mothers and fathers, and with poorer and more crowded families (p < 0.01, p < 0.01 and p < 0.01, p < 0.001, respectively). The rate of iodine deficiency was significantly higher in females than in males and also higher in children who lived on the European side of Istanbul than on the Anatolian side of Istanbul (p < 0.0001, p < 0.0001, respectively). The rate of use of iodized salt was 44.4 per cent and the iodine deficiency rate was not affected by the use of iodized salt (p > 0.05). Although the median urine iodine level was in the normal range, in 46.2 per cent of the students urine iodine levels were low (< 10 microg/dl). As there seems to be no effect from the use of iodized salt in iodine deficiency, the use of a more stable potassium iodate for the fortification of salt may be required.

Anemic or not?

Laboratory data obtained from blood analysis by an electronic cell counter is a routine test along with physical evaluation. We assessed the hematological characteristics of schoolchildren to establish the prevalence of anemia in Istanbul. The study was performed on 1,600 students between the ages of 6-16. Hematological parameters of all the students were measured by an electronic cell counter on blood taken intravenously. Anemia prevalence was primarily determined according to Dallman's criteria. The results showed that if hemoglobin (Hb) was used as the primary criterion to define anemia, 423 students (27.6%) were found anemic; if hematocrit (Hct) was used, 625 students (40.8%) were found anemic and if mean corpuscular volume (MCV) was taken as a criterion to define microcytosis, 121 students (7.9%) remained below the normal level. The difference of anemia prevalence was high (p < 0.001) when two evaluation criteria (Hb or Hct) were compared. Furthermore it is known that a 3% difference occurs when automated and spun Hct values are compared. When a correction was made by adding this 3% to our series' Hct values, the anemic students' number decreased to 418 and the ratio became 27.3%, quite similar to Hb criterion ratio. Population based screening surveys for anemia must be designed and compared cautiously taking into account the method used (electronic counters or gravity based centrifuges), otherwise misleading results can be achieved. We evaluated the data of the survey according to different cut-off values and tried to select the proper one for our conditions.