Evaluation of palmar pallor, pica and parasitic infestation as screening tools for iron deficiency anemia among lry school children

Abstract EN

Background: Worldwide, iron deficiency is the most common cause of anemia.

It is a common disease in Egypt, with a very high prevalence rate.

Selective screening on the basis of history-taking and clinical examination to identify the risk factors that warrant a blood test for anemia has been advocated.

Aims: The aim of the present study was to evaluate the value of some clinical variables as screening tests for iron deficiency anemia (IDA) in primary school children.

The Specific objectives were to define the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of pallor, pica and parasitic infestation in screening for IDA among primary school children.

Methods: A cross sectional design was used.

A sample size of 477 was calculated from the target population (24000 children distributed among 43 lry Schools in Ismailia City, Egypt).

The estimated study sample was selected randomly, simple randomization, by using the random numbers and screened for anemic children with low ferritin levels (<12 u.g/L).

Complete history, clinical examination and stool analysis were carried out for every child in the study group.

The presence and absence of the different screening variables (palmar pallor, pica and parasitic infestation) were matched with the presence and absence of IDA among children.

Results: IDA was confirmed in 126(26.4%) children.

Pallor was the most frequent sign {diagnosed in 96 (20.1%) children} followed by parasitic infestation {76 (15.9%)).

The sensitivity; specificity; PPV; and NPV were determined for palmar pallor (59.5%, 94.0%, 78.1% and 86.6% respectively), pica (37.7%; 96.6%, 79.7 and 96.6% respectively) and parasitic'infestation (39.7%, 92.5%, 65.7% and 81.0% respectively).

Conclusion: In areas where IDA and parasitic infestation are prevalent, palmar pallor + parasitic infestation should attract the attention of the health care provider for either hematological investigation for confirmation of the diagnosis or direct treatment of IDA.