Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study

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.

Prevalence of microcytic hypochromic anemia and their assosiated risk factor among female students of Sarhad University Peshawar, Pakistan

“…Nutritional Survey 2018, the prevalence of IDA in children is 28.6%. The proportion of IDA in urban boys was 29.1% and 28.9% in rural areas (Sherali et al, 2023).…”

“…This problem is most commonly faced by young females of 18 to 25 years of age. Global Prevalence of iron deficiency anemia was 50% among the females of reproductive age (Sherali et al, 2023). According to WHO the recommended Hemoglobin level, for nonpregnant women (age 15 and over) is 120 gm/L and for males (15 years and over) it is 130 gm/L (Mawani & Aziz Ali, 2016).…”

Diagnostic Accuracy of Mentzer Index as a Screening Tool for the Diagnosis of Iron Deficiency Anemia by Taking Iron Profile as Gold Standard in Patients Presenting With Hypochromic Microcytic Anemia at Tertiary Care Hospital, Karachi

“…Nevertheless, according to the 2018 National Nutritional Survey, the incidence of IDA is 28.6%, with males in urban areas accounting for 29.1% of cases and rural regions accounting for 28.9% (Ullah et al, 2016). Concerning disability-adjusted life years, IDA is the 13th most important risk factor and the third most common cause of impairment worldwide (Sherali et al, 2023). IDA has been linked to low birth rates in Pakistan (Akhtar et al, 2017), delayed brain development in under-five children, and reduced growth and intellectual capacities.…”

“…IDA and anemia are sometimes used synonymously; nevertheless, in certain instances, IDA has been shown to induce tissue damage on its own. Stages from inadequate iron intake to decreased iron storage and hemoglobin synthesis are typically involved in IDA (Sherali et al, 2023). Its sensitivity and specificity make the Mentzer Index stand out among the many other used indices.…”

Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC

“…These include the Mentzer index, the Srivastava index, the Shine and Lal index, the Green and King index, the RBCs distribution width , England and the fastest RBCs index (7).…”