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Screening of iron deficiency anaemia in early childhood
1Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain. sophjullien@gmail.com.
Insights
Universal screening for iron deficiency anaemia (IDA) in young children is not widely recommended due to a lack of evidence and accurate non-invasive tests. Selective screening for at-risk infants is advised.
Area of Science:
- Pediatrics
- Public Health
- Hematology
Background:
- Iron deficiency anaemia (IDA) is a common nutritional deficiency in young children.
- Concerns exist regarding the impact of IDA on child development, including growth, cognition, and psychomotor skills.
- The effectiveness and safety of universal screening for IDA in children under five years old require thorough evaluation.
Purpose of the Study:
- To review existing recommendations and evidence on universal IDA screening in children under five.
- To assess screening test accuracy, treatment efficacy, and potential harms.
- To inform clinical practice and public health policy regarding IDA screening.
Main Methods:
- A comprehensive literature search was conducted up to August 18, 2019.
- Recommendations from major health organizations were summarized.
- Findings from systematic reviews on screening accuracy, treatment, and harms were synthesized.
Main Results:
- No non-invasive screening tests for IDA demonstrate high accuracy.
- There is uncertainty regarding the causal link between IDA and developmental delays in children.
- Limited evidence exists on the impact of routine IDA screening on asymptomatic children's development.
Conclusions:
- Most organizations do not recommend universal IDA screening for children under five.
- Selective screening for infants with risk factors (e.g., prematurity, low birth weight, dietary issues) is recommended.
- Further research is needed to establish the benefits and harms of universal IDA screening.
Abstract:
We looked at existing recommendations and supporting evidence on the effectiveness of universal screening of iron deficiency anaemia (IDA) in children under five years of age for improving growth, cognitive function, and psychomotor development. We assessed the accuracy of the screening tests for detecting IDA, the efficacy of existing treatment for children with IDA, and the potential harms associated with screening and treatment.We conducted a literature search up to the 18th of August 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.There is no suitable test for IDA screening that is non-invasive with high accuracy for detecting IDA and there is uncertainty whether IDA in children causes cognitive and psychomotor delays. There is a lack of evidence on the effects of routine screening for IDA in asymptomatic children under five years of age on growth, cognitive and psychomotor development outcomes.Universal screening of IDA in children under five years of age is not recommended by most organisations such as the Spanish Association of Primary Care Paediatrics, the United Kingdom National Screening Committee, and the United States Preventive Services Task Force, but is recommended by the American Academy of Paediatrics. However, selective screening of IDA is recommended in infants and children with risk factors including prematurity, low birth weight, and dietary risk factors.
