A comparative study on selected iron status assessment assays among secondary school students in Bauchi State, Nigeria

Iron deficiency anemia (IDA) is the most common form of anemia worldwide, with highest burden in developing countries. The assays used in detecting iron deficiency comprise of red blood cell indices such as Mean Corpuscular Hemoglobin and Mean Corpuscular Volume, serum ferritin, soluble transferrin receptor (STfR) and STfRL-index. Each of these assessment tools has its drawback(s). This study was conducted to assess IDA diagnostic inter-rater agreements between red cell indices, serum ferritin, STfR and STfLF-Index. A cross sectional descriptive study using systematic random sampling of eligible secondary school students in Misau LGA, Bauchi State, Nigeria. Complete Blood Count with cellular indices, serum ferritin and STfR assays were conducted. Data was analyzed using SPSS version 23.0. Proportions were compared using Z-tests of proportions. Cohen’s Un-weighted kappa analyses were used to assess pairwise agreements in the ability of STfLF-Index, serum ferritin, STfR and red cell indices to classify participants into IDA and non-IDA. Level of significance was set at P≤0.05. A total of 210 participants were enrolled in the study with females constituting 153 (72.9%). STfLF-Index, STfR, serum ferritin levels and red cell indices revealed that 130/210 (61.9%), 160/210(76.2%), 7/210 (3.3%) and 112/210 (53.3%) respectively had iron deficiency. STfR revealed a significantly higher percentage of students with iron deficiency compared to serum ferritin, STfLF-Index and red cell indices. Assessment of iron deficiency showed concurrence between STfR and STfLF-Index. STfR and STfLF-Index have similar ability in classifying iron status.