Recognition of pallor associated with severe anaemia by primary caregivers in western Kenya
- 2 October 2002
- journal article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 7 (10), 831-839
- https://doi.org/10.1046/j.1365-3156.2002.00942.x
Abstract
To explore which pallor signs and symptoms of severe anaemia could be recognized by primary caregivers following minimal instructions. Data from three community-based cross-sectional surveys were used. Test characteristics to predict haemoglobin (Hb) concentrations < 5 and < 7 g/dl were compared for different combinations of pallor signs (eyelid, tongue, palmar and nailbed) and symptoms. Pallor signs and haemoglobin levels were available for 3782 children under 5 years of age from 2609 households. Comparisons of the sensitivity and specificity at a range of haemoglobin cut-offs showed that Hb < 5 g/dl was associated with the greatest combined sensitivity and specificity for pallor at any anatomical site (sensitivity = 75.6%, specificity = 63.0%, Youden index = 38.6). Higher or lower haemoglobin cut-offs resulted in more children being misclassified. Similar results were obtained for all individual pallor sites. Combining a history of soil eating with pallor at any site improved the sensitivity (87.8%) to detect Hb < 5 g/dl with a smaller reduction in specificity (53.3%; Youden index 41.1). Other combinations including respiratory signs or poor feeding resulted in lower accuracy. Primary caregivers can recognize severe anaemia (Hb < 5 g/dl) in their children, but only with moderate accuracy. Soil eating should be considered as an additional indicator of severe anaemia. The effect of training caretakers to improve recognition of severe anaemia and care-seeking behaviour at the household level should be assessed in prospective community-based studieThis publication has 13 references indexed in Scilit:
- Clinical use of WHO haemoglobin colour scale: validation and critiqueJournal of Clinical Pathology, 2000
- The Significance of Earth-Eating: Social and Cultural Aspects of Geophagy Among Luo ChildrenAfrica, 2000
- Field trial of a haemoglobin colour scale: an effective tool to detect anaemia in preschool childrenTropical Medicine & International Health, 2000
- Analysis of repeated hemoglobin measures in full-term, normal birth weight Kenyan children between birth and four years of age. III. The Asemobo Bay Cohort Project.The American Journal of Tropical Medicine and Hygiene, 1999
- Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission I. Description of study site, general methodology, and study population.The American Journal of Tropical Medicine and Hygiene, 1999
- Geophagy, iron status and anaemia among primary school children in Western KenyaTropical Medicine & International Health, 1998
- An inexpensive and reliable new haemoglobin colour scale for assessing anaemia.Journal of Clinical Pathology, 1998
- Child malaria treatment practices among mothers in KenyaSocial Science & Medicine (1982), 1995
- Plasmodium falciparum Incidence Relative to Entomologic Inoculation Rates at a Site Proposed for Testing Malaria Vaccines in Western KenyaThe American Journal of Tropical Medicine and Hygiene, 1994
- Effect of blood transfusion on survival among children in a Kenyan hospitalThe Lancet, 1992