Proficiency of Pallor in Predicting Anemia.

Abstract

Introduction: Anemia is one of the most commonly encountered hematologic disease of infancy and childhood. More than 75% of Indian children under 36 months of age are found to be anemic. Iron-deficiency anemia (IDA) has been found to be correlated with decreased cognitive performance in many studies, hence prompt diagnosis and treatment are necessary. Pallor is a clinical sign in the diagnosis of anemia. Current research aimed to study about the predictive value of pallor in various sites and its relation to anemia. Material and methods: 500 children attending the outpatient department of pediatrics were evaluated for clinical pallor and Hemoglobin was estomated by cyanmethemoglobin method. Results: When the various parameters were compared between conjunctival, palmar, mucosal and nail bed pallor; it has been observed that sensitivity was highest for nail bed pallor in the evaluation of anemia. Specificity was highest for conjunctival pallor. The positive predictive value and negative predictive value were both highest for conjunctival pallor and least for palmar pallor. However, when all the evaluated parameters were compared in patients with severe anemia, highest sensitivity and specificity was observed for palmar pallor. The positive predictive value was highest for palmar pallor and least for nail bed pallor. The negative predictive value was highest for conjunctival pallor and least for nail bed pallor. Conclusion: Clinical pallor of the nailbeds had highest sensitivity for detection of moderate anemia while palmar pallor had the highest sensitivity for the detection of severe anemia. These are simple clinical signs which can be read even by non doctors and can thus be taught to various personnel like health workers and school teachers for early detection and prompt management of anemia in children below 5 years.