Noninvasive Colour-Based Card for Risk Assessment of Anaemia in Children: PAN-India User Experience

Article Sidebar

11-July-5465.pdf
Published Jul 26, 2024
DOI: https://doi.org/10.18103/mra.v12i7.5465

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

G Kulkarni
Sanjeevani Children’s Hospital, Aurangabad, Maharashtra, India
J Dekhne
Kartik Children’s Hospital, Unique Children’s Hospital, Pune, India
B Rajsekhar
Associate Medical Director and Senior Consultant Paediatrician, Giggles by Omni Hospital, Visakhapatnam, India
A S Kumar
Professor in Pediatrics, Azeezia Medical College, Kollam, India
T Anand
Advance Pediatric Centre, Lucknow, India
L K Garg
Dr. Garg Pediatric Clinic, Agra, India
K Chakrabarti
Consultant Pediatrician, Child Healthcare, Bankura, West Bengal, India
A A Mirza
Consultant Neonatologist & Pediatrician, Kisholoy Children’s Hospital, Burdwan, West Bengal, India
R K Joshi
Senior Consultant Pediatrics and Neonatology, Apollo Hospitals, Bhubaneswar, India
A G Karthikeyan
Senior Consultant Paediatrician & Neonatologist, Sai Mother & Child Health Centre & Sakthi Hospital & Research centre, Chennai, India
B Yadav
Senior Biostatistician, Christian Medical College, Vellore, Tamil Nadu, India.

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.

Keywords: Anemia, Non-invasive, Children, Screening tool, Sensitivity, Specificity, Colour-based card

Article Details

How to Cite
KULKARNI, G et al. Noninvasive Colour-Based Card for Risk Assessment of Anaemia in Children: PAN-India User Experience. Medical Research Archives, [S.l.], v. 12, n. 7, july 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5465>. Date accessed: 15 nov. 2024. doi: https://doi.org/10.18103/mra.v12i7.5465.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 12 No 7 (2024): Vol 12 No 7 (2024): July issue
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. World Health Organization. World Health Organization. Haemoglobin concentrations for the diagnosis of anemia and assessment of severity. Available at: https://iris.who.int/bitstream/handle/10665/85839/WHO_NMH_NHD_MNM_11.1_eng.pdf. Accessed on 17 April, 2024.
2. Safiri S, Kolahi AA, Noori M, et al. Burden of anemia and its underlying causes in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. J Hematol OncolJ Hematol Oncol. 2021;14(1):185. Doi:10.1186/s13045-021-01202-2
3. Ministry of Health and Family Welfare. Government of India. National Family Health Survey (NFHS-3), 2005-2006. Available at : https://dhsprogram.com/pubs/pdf/frind3/frind3-vol1andvol2.pdf. Last accessed on 17 April, 2024.
4. Ministry of Health and Family Welfare. Government of India. National Family Health Survey (NFHS-5), 2019-2021. Available at: NFHS-5_INDIA_REPORT.pdf (rchiips.org). Last accessed on 17 April, 2024.
5. Ministry of Health and Family Welfare. Government of India. National Family Health Survey (NFHS-4), 2015-2016. Available at: 60263_National_Report_Full File 05-07-2018 WEB.pdf (rchiips.org). Last accessed on 17 April, 2024.
6. Kohli-Kumar M. Screening for anemia in children: AAP recommendations--a critique. Pediatrics. 2001;108(3):E56. Doi:10.1542/peds.108.3.e56
7. Jullien S. Screening of iron deficiency anemia in early childhood. BMC Pediatr. 2021;21(Suppl 1):337. Doi:10.1186/s12887-021-02725-w
8. Sheth TN, Choudhry NK, Bowes M, Detsky AS. The relation of conjunctival pallor to the presence of anemia . J Gen Intern Med. 1997;12(2):102-106. Doi:10.1046/j.1525-1497.1997.00014.x
9. Kalantri A, Karambelkar M, Joshi R, Kalantri S, Jajoo U. Accuracy and reliability of pallor for detecting anemia: a hospital-based diagnostic accuracy study. PloS One. 2010;5(1):e8545. Doi:10.1371/journal.pone.0008545
10. Khan AA, Fatmi Z, Kadir MM. Accuracy and Use of WHO Hemoglobin Color Scale for Diagnosis of Anemia Among Pregnant Women by Health Care Providers in Periurban Settings in Karachi, Pakistan. Asia Pac J Public Health. 2015;27(6):610-619. Doi:10.1177/1010539515588777
11. Marn H, Critchley JA. Accuracy of the WHO Haemoglobin Colour Scale for the diagnosis of anemia in primary health care settings in low-income countries: a systematic review and meta-analysis. Lancet Glob Health. 2016;4(4):e251-265. Doi:10.1016/S2214-109X(16)00005-X
12. Chowdhury MEEK, Chongsuvivatwong V, Geater AF, Akhter HH, Winn T. Taking a medical history and using a colour scale during clinical examination of pallor improves detection of anemia. Trop Med Int Health TM IH. 2002;7(2):133-139. Doi:10.1046/j.1365-3156.2002.00837.x
13. Clinic For Children, Coimbatore, Tamil Nadu, Kumaran N, S G, NIVI Hospital, Dindigul, Tamil Nadu. Noninvasive Color-Based Shade card for Risk Assessment of Anemia in Young Children: A Real-World User Experience. J Pediatr Res Rev Rep. Published online April 30, 2023:1-7. Doi:10.47363/JPRRR/2023(5)151
14. Shreffler J, Huecker MR. Diagnostic Testing Accuracy: Sensitivity, Specificity, Predictive Values and Likelihood Ratios. In: StatPearls. StatPearls Publishing; 2024. Accessed April 18, 2024. http://www.ncbi.nlm.nih.gov/books/NBK557491/
15. Getaneh T, Girma T, Belachew T, Teklemariam S. The utility of pallor detecting anemia in under five years old children. Ethiop Med J. 2000;38(2):77-84.
16. 16. Aggarwal AK, Tripathy JP, Sharma D, Prabhu A. Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6-59 Months in North India. Anemia . 2014;2014:543860. Doi:10.1155/2014/543860
17. Luby SP, Kazembe PN, Redd SC, et al. Using clinical signs to diagnose anemia in African children. Bull World Health Organ. 1995;73(4):477-482.
18. Ughasoro MD, Madu AJ, Kela-Eke IC, Akubuilo U. Parental Perception of Childhood Anemia and Efficiency of Instrument Assisted Pallor Detection among Mothers in Southeast Nigeria: A Field Validation Study. Int J Pediatr. 2019;2019:7242607. Doi:10.1155/2019/7242607
19. Critchley J, Bates I. Haemoglobin colour scale for anemia diagnosis where there is no laboratory: a systematic review. Int J Epidemiol. 2005;34(6):1425-1434. Doi:10.1093/ije/dyi195
20. Perez-Plazola MS, Tyburski EA, Smart LR, et al. AnemoCheck-LRS: an optimized, color-based point-of-care test to identify severe anemia in limited-resource settings. BMC Med. 2020;18(1):337. Doi:10.1186/s12916-020-01793-6
21. McLennan JD, Steele M. Anemia Screening and Treatment Outcomes of Children in a Low-resource Community in the Dominican Republic. J Trop Pediatr. 2016;62(2):116-122. Doi:10.1093/tropej/fmv084
22. Suner S, Crawford G, McMurdy J, Jay G. Non-Invasive Determination of Hemoglobin by Digital Photography of Palpebral Conjunctiva. J Emerg Med. 2007;33(2):105-111. Doi:10.1016/j.jemermed.2007.02.011
23. Tamir A, Jahan CS, Saif MS, et al. Detection of anemia from image of the anterior conjunctiva of the eye by image processing and thresholding. In: 2017 IEEE Region 10 Humanitarian Technology Conference (R10-HTC). IEEE; 2017:697-701. Doi:10.1109/R10-HTC.2017.8289053
24. Dimauro G, Caivano D, Girardi F. A New Method and a Non-Invasive Device to Estimate Anemia Based on Digital Images of the Conjunctiva. IEEE Access. 2018;6:46968-46975. Doi:10.1109/ACCESS.2018.2867110
25. Pintavirooj C, Ni B, Chatkobkool C, Pinijkij K. Noninvasive Portable Hemoglobin Concentration Monitoring System Using Optical Sensor for Anemia Disease. Healthcare. 2021;9(6):647. Doi:10.3390/healthcare9060647