Abstract
Background: Easy-to-use inexpensive tools are needed for the detection and timely intervention for anemia in children. As an extension of an earlier user-experience in 9 paediatricians, we present real-world experience of 84 paediatricians for the assessment of anemia with the use of the Non-invasive Screening of Anemia (NISA) colour-based shade card in 1459 children aged 6- 60 months.
Methods: The NISA shade card was used to determine the presence and severity (mild, moderate, severe) of anemia by comparing the natural colour tint or pallor of palpebral conjunctiva with 13 ordinal shades. A feedback questionnaire was used to assess the experience of using the NISA card. Results were summarized using descriptive statistics.
Results: The sensitivity and specificity of the NISA shade card for detection of anemia were 80.83% (95% CI: 72.64% to 87.44%) and 66.04% (95% CI: 51.73% to 78.48%) respectively. The NISA card had an accuracy of 81.28%; this ranged from 77.74% to 85.23% in different regions across India. Most clinicians rated the NISA card as good to excellent for its utility in screening for anemia especially in situations where drawing of blood could be avoided.
Conclusion: With an accuracy and sensitivity of >80%, the NISA shade card is a simple tool that can easily be deployed in community settings for the assessment of anemia. The tool can find its extended use in planning and implementing nutritional practices in children.