World Health Organization Hemoglobin Cut-Off Points for the Detection of Anemia Are Valid for an Indonesian Population

Abstract

The study was designed to determine whether population-specific hemoglobin cut-off values for detection of iron deficiency are needed for Indonesia by comparing the hemoglobin distribution of healthy young Indonesians with that of an American population. This was a cross-sectional study in 203 males and 170 females recruited through a convenience sampling procedure. Hemoglobin, iron biochemistry tests and key infection indicators that can influence iron metabolism were analyzed. The hemoglobin distributions, based on individuals without evidence of clear iron deficiency and infectious process, were compared with the National Health and Nutrition Survey (NHANES) II population of the United States. Twenty percent of the Indonesian females had iron deficiency, but no male subjects were iron deficient. The mean hemoglobin of Indonesian males was similar to the American reference population at 152 g/L with comparable hemoglobin distribution. The mean hemoglobin of the Indonesian females was 2 g/L lower than that of the American reference population, which may be the result of incomplete exclusion of subjects with milder form of iron deficiency. When the WHO cutoff (Hb < 120 g/L) was applied to female subjects, the sensitivity of 34.2% and specificity of 89.4% were more comparable to the test performance for white American women, in contrast to those of the lower cut-off. On the basis of the finding of hemoglobin distribution of men and the test performance of anemia (Hb < 120 g/L) for detecting iron deficiency for women, it is concluded that there is no need to develop different cut-off points for anemia as a tool for iron-deficiency screening in this population.

Assessment and interpretation of micronutrient status during pregnancy

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Association between Anemia and Aflatoxin B1 Biomarker Levels among Pregnant Women in Kumasi, Ghana

“…Although anemia is a global health problem, it occurs more frequently among children and pregnant women in developing countries. 5 Only 23% of pregnant women in industrialized countries are anemic compared with 52% of their counterparts in less developed countries. Up to 18% of women in developed countries and 43% of those in developing countries are already anemic at the time of conception.…”

Neutrophil-to-Lymphocyte Ratio, Plateletto- Lymphocyte Ratio, and Red Blood Cell Distribution Width as New Biomarkers in Patients with Colorectal Cancer

“…The preoperative hemoglobin levels, lymphocyte counts, platelet counts, and RDW values of the patients were noted from the records. In cancer patients and healthy participants, anemia was defined using the World Health Organization criteria of hemoglobin levels of <13 g/dL for men and <12 g/dL for women (9). NLR and PLR were calculated by dividing the neutrophil and platelet counts by the lymphocyte count, all of which were obtained from the preoperative complete blood counts of the patients.…”