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Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study
Atika Sherali1, Abdul Ahad1, Shiyam Sunder Tikmani2
1Liaquat National Hospital, Karachi, Pakistan.
Insights
The Mentzer Index accurately identifies iron deficiency anemia (IDA) in children, showing high sensitivity and specificity. This tool aids in the early detection of IDA in pediatric patients.
Area of Science:
- Pediatric Hematology
- Diagnostic Accuracy Studies
- Clinical Pathology
Background:
- Hypochromic microcytic anemia is common in children.
- Differentiating iron deficiency anemia (IDA) from other causes is crucial for timely treatment.
- The Mentzer Index is a simple, cost-effective screening tool.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Mentzer Index for identifying IDA in children.
- To compare the Mentzer Index against serum ferritin levels as the gold standard.
- To determine the sensitivity, specificity, and predictive values of the Mentzer Index.
Main Methods:
- A cross-sectional study involving 347 children aged 1-5 years.
- Exclusion criteria included blood transfusions, thalassemia, chronic diseases, malignancy, and congenital abnormalities.
- Complete blood count (CBC) and serum ferritin levels were analyzed.
Main Results:
- The Mentzer Index demonstrated a sensitivity of 80.7% and specificity of 77.7%.
- Negative predictive value (NPV) was high at 91.6%, while positive predictive value (PPV) was 56.8%.
- Overall diagnostic accuracy was 78.4% with a likelihood ratio of 3.6.
Conclusions:
- The Mentzer Index is a valuable tool for the early detection of IDA in children.
- Its high sensitivity and specificity support its use in resource-limited settings.
- Further research may explore its utility in diverse pediatric populations.
Abstract:
The objective of the study was to determine the diagnostic accuracy of Mentzer Index in children with hypochromic microcytic anemia by taking serum ferritin levels as a gold standard. This cross-sectional study was conducted in the Department of Pediatric Medicine, Liaquat National Hospital Karachi, from 1st January to 30th June 2022. Children age 1 to 5 years and both genders were included in this study. Children who have had a history of blood transfusion in the past 3 months or Thalassemia or blood disorders, chronic liver disease or kidney diseases, and children with malignancy and congenital abnormalities were excluded. Eligible children were enrolled after taking written informed consent. Complete blood count (CBC) and serum ferritin were sent to the laboratory. Sensitivity, specificity, diagnostic accuracy, and likelihood ratio were calculated taking serum ferritin levels as a gold standard. A total of 347 subjects were enrolled. The median age was 26 (IQR-18) months and 42.9% were males. The most common symptom was fatigue 40.9%. The sensitivity of the Mentzer index was 80.7% while the specificity was 77.7%. Similarly, the positive predictive value (PPV) was 56.8% while the negative predictive value (NPV) was 91.6%. Finally, the accuracy of the Mentzer index in determining iron deficiency anemia was 78.4%. Diagnostic accuracy was 78.4% and the likelihood ratio was 3.6. Mentzer index is a valuable tool in the early detection of IDA in children. It has got high sensitivity, specificity diagnostic accuracy, and likelihood ratio.
