Reliability and validity of clinical signs for anemia detection in school children

Journal Title: Medpulse International Journal of Pediatrics - Year 2019, Vol 9, Issue 1


Anemia is widely prevalent in developing world and also is a public health challenge in India. It is a serious concern because it can result in impaired cognitive performance, behavioural and motor development, coordination, language development, and scholastic performance. It also leads to increased morbidity from infectious diseases. The present study was designed to evaluate the accuracy and reliability of clinical signs in children by studying their sensitivity and specificity in comparison to haemoglobin assessment in diagnosis of anaemia and to study the inter-observer agreement of pallor examination to diagnose anaemia in urban school children 6-14 years of age in this region. An Observational cross- sectional study was conducted among school children aged 6–14 years in urban government schools from January 2017 to January 2018. In this study, 450 urban government school children in age group of 6-14 years were included and they were observed by two separate doctors for clinical signs of Anemia. 54 students were excluded. The incidence of Anemia was 60% i.e. 237 children out of 394. Both doctors found that palmar pallor had highest sensitivity when Anemia was severe. The sensitivity for mild and moderate was quite low. Specificity of all sites was high and for severe pallor was 100%. Fleiss Kappa was used as a measure to review inter observer reliability at the different sites. It is to be noted that the Kappa for all sites are above 0.8 which indicates an almost perfect agreement on the pallor between the 2 observers. In the present study, the prevalence of Anemia was high in school children. According to the present study conjunctiva and palm were the most sensitive to assess the severity of Anemia. Clinical assessment of pallor can be used as initial screening tool for diagnosing Anemia in school children especially in places where prevalence in high and early incorporation of treatment.

Authors and Affiliations

Srikrishna S, Nagendra Prasad K, Natasha Ahmad, Ravi kiran M, Ajay Kumar Reddy Bobba


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  • EP ID EP443809
  • DOI 10.26611/1014912
  • Views 109
  • Downloads 0

How To Cite

Srikrishna S, Nagendra Prasad K, Natasha Ahmad, Ravi kiran M, Ajay Kumar Reddy Bobba (2019). Reliability and validity of clinical signs for anemia detection in school children. Medpulse International Journal of Pediatrics, 9(1), 3-8.