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Updated: Jun 25, 2026
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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
A Dynamic, Continuous Model for Age-Specific Anemia Classification in Children and Non-Pregnant Women
Charles P Wakim1, Carla A El-Mallah2, James P Wirth2
1Department of Nutrition and Food Sciences, Faculty of Agricultural Sciences, American University of Beirut, Beirut, Lebanon.
The Journal of Applied Laboratory Medicine
|June 23, 2026
Summary
A new dynamic model for anemia detection improves classification accuracy, especially in young children, by accounting for age-related hemoglobin variations. This approach offers a more precise understanding of anemia prevalence compared to fixed cutoffs.
Area of Science:
- Hematology
- Pediatrics
- Public Health
Background:
- Fixed hemoglobin cutoffs for anemia diagnosis overlook physiological age-related variations.
- This can lead to misclassification, particularly in early childhood.
- A dynamic, continuous model based on hemoglobin-age relationships is proposed to address these limitations.
Purpose of the Study:
- To develop and evaluate a dynamic, continuous model for anemia classification using age-specific hemoglobin thresholds.
- To compare anemia prevalence estimates from the dynamic model with current WHO fixed cutoffs.
- To assess the impact of the dynamic model on reducing misclassification, especially in vulnerable age groups.
Main Methods:
- Secondary data analysis of the Lebanon Integrated Micronutrient, Anthropometry and Child Development Survey 2023 (LIMA-2023).
- Polynomial regression applied to hemoglobin distributions in a healthy reference population to derive continuous, age-specific anemia thresholds.
- Comparison of anemia prevalence and misclassification patterns between the dynamic model and WHO 2024 fixed criteria in children (6-59 months) and women (10-50 years).
Main Results:
- The dynamic model indicated a higher prevalence of anemia in children aged 6-59 months compared to WHO 2024 criteria, especially for mild and severe cases.
- Anemia estimates for older children and women were comparable between the two models.
- The continuous model effectively captured age-dependent physiological trends and reduced misclassification associated with fixed thresholds.
Conclusions:
- Fixed hemoglobin cutoffs are insufficient for accurately reflecting age-related physiological changes in anemia assessment.
- A dynamic, continuous model provides a more refined approach to anemia classification, particularly beneficial for early childhood.
- This improved classification can lead to more accurate epidemiological data and public health interventions.
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