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Reticulocyte hemoglobin equivalent as a diagnostic parameter of iron deficiency anemia in infants age 1-4 months
Harapan Parlindungan Ringoringo1, Lina Purnama Sari2, Ari Yunanto2
1Department of Child Health, Faculty of Medicine, Lambung Mangkurat University - RSD Idaman Banjarbaru, Banjarbaru, South Kalimantan, Indonesia.
Insights
Reticulocyte hemoglobin equivalent (Ret-He) effectively diagnoses iron deficiency and iron deficiency anemia in infants aged 1-4 months. This parameter shows high specificity and positive predictive value for early detection in this vulnerable population.
Area of Science:
- Pediatrics
- Hematology
- Clinical Diagnostics
Background:
- Iron deficiency anemia (IDA) is a significant global health issue, particularly affecting children under five.
- Dietary iron deficiency (ID) is the primary cause of IDA in infants.
- Reticulocyte hemoglobin equivalent (Ret-He) is a diagnostic marker for iron deficiency.
Purpose of the Study:
- To evaluate the diagnostic utility of Ret-He for iron deficiency (ID) and IDA in infants aged 1-4 months.
- To establish Ret-He cut-off values for diagnosing ID and IDA in this age group.
Main Methods:
- Prospective study conducted at 10 community health centers from August 2020 to August 2021.
- Included 403 infants aged 1-4 months.
- Analyzed venous blood samples for Ret-He, complete blood count, and peripheral blood smears.
Main Results:
- The incidence of ID and IDA in infants 1-4 months was 10.9% and 58.6%, respectively.
- Established Ret-He cut-off values for iron deficiency and IDA at 1, 2, 3, and 4 months.
- Demonstrated high specificity (94.4%-98.1%) and positive predictive value (66.7%-85.7%) for Ret-He in diagnosing ID and IDA.
Conclusions:
- Ret-He is a valuable diagnostic tool for detecting iron deficiency and IDA in infants aged 1-4 months.
- The parameter exhibits high specificity and positive predictive value, aiding in early diagnosis.
Introduction:
Iron deficiency anemia (IDA) is still a major global health problem. The prevalence was reported to be highest among children under 5 years, 39.7%, with the primary contributing cause being dietary iron deficiency (ID). Reticulocyte hemoglobin equivalent (Ret-He) assesses the amount of hemoglobin in reticulocytes. Ret-He is an easy, inexpensive, and applicable diagnostic parameter of iron deficiency. This study aims to determine the role of Ret-He as a diagnostic parameter of ID and IDA in infants 1-4 months old.
Material And Methods:
The study was conducted prospectively at 10 Community Health Centers in Banjarbaru, South Kalimantan, from August 2020 to August 2021. In total, 403 infants aged 1, 2, 3, and 4 months met the inclusion and exclusion criteria. Venous blood samples were checked for Ret-He, complete blood count, and peripheral blood smears.
Results:
The incidence of ID and IDA in infants 1-4 months was 10.9% and 58.6%. Ret-He cut-off values for iron deficiency and IDA at 1, 2, 3 and 4 months were 22.25 pg, 20.3 pg, 19.05 pg and 17.55 pg, with sensitivity 7.8%, 2.5%, 7.4%, 8.2%, specificity 94.4%, 95.0%, 96.9%, 98.1%, positive predictive value 85.7%, 66.7%, 83.3%, 80.0%, and negative predictive value 18.1%, 19.6%, 33.0%, 53.6%.
Conclusions:
Ret-He can detect iron deficiency and IDA in a 1-4-month-old baby with high specificity and positive predictive value.
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