Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India
Introduction. The Integrated Management of Childhood and Neonatal Illness (IMNCI) recommends the use palmar pallor to diagnose anaemia. Earlier studies to validate palmar pallor as clinical sign for anaemia were largely done in African context. There was a need to test validity of palmar pallor to d...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Anemia |
| Online Access: | http://dx.doi.org/10.1155/2014/543860 |
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| author | Arun Kumar Aggarwal Jaya Prasad Tripathy Deepak Sharma Ajith Prabhu |
| author_facet | Arun Kumar Aggarwal Jaya Prasad Tripathy Deepak Sharma Ajith Prabhu |
| author_sort | Arun Kumar Aggarwal |
| collection | DOAJ |
| description | Introduction. The Integrated Management of Childhood and Neonatal Illness (IMNCI) recommends the use palmar pallor to diagnose anaemia. Earlier studies to validate palmar pallor as clinical sign for anaemia were largely done in African context. There was a need to test validity of palmar pallor to detect anemia in different settings. Objective. To study the validity and interobserver agreement of palmar pallor examination to diagnose anemia in children under 5 years of age in India. Methods. In a village in Northern India, hemoglobin estimation was done for 80 children using cyanomethemoglobin method. Two examiners, a physician and a health worker, trained in IMNCI evaluated children for palmar pallor. Sensitivity and specificity and Kappa statistics were calculated. Results. Health worker diagnosed palmar pallor with sensitivity of 30.8–42.8% and specificity of 70–89%. Similar figures for doctor were 40–47% and 60–66%, respectively. Kappa agreement between a health worker and a physician was 0.48 (95% CI = 0.298–0.666) and then increased to 0.51 when categories of severe pallor and mild pallor were merged. Conclusion. While using palmar pallor as clinical sign for anaemia, children with no pallor should also be followed up closely for possible detection of missed cases during follow-up. |
| format | Article |
| id | doaj-art-c0e745c6f007475c880868378a690f1b |
| institution | Kabale University |
| issn | 2090-1267 2090-1275 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anemia |
| spelling | doaj-art-c0e745c6f007475c880868378a690f1b2025-02-03T01:09:13ZengWileyAnemia2090-12672090-12752014-01-01201410.1155/2014/543860543860Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North IndiaArun Kumar Aggarwal0Jaya Prasad Tripathy1Deepak Sharma2Ajith Prabhu3School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaSchool of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaSchool of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaSchool of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, IndiaIntroduction. The Integrated Management of Childhood and Neonatal Illness (IMNCI) recommends the use palmar pallor to diagnose anaemia. Earlier studies to validate palmar pallor as clinical sign for anaemia were largely done in African context. There was a need to test validity of palmar pallor to detect anemia in different settings. Objective. To study the validity and interobserver agreement of palmar pallor examination to diagnose anemia in children under 5 years of age in India. Methods. In a village in Northern India, hemoglobin estimation was done for 80 children using cyanomethemoglobin method. Two examiners, a physician and a health worker, trained in IMNCI evaluated children for palmar pallor. Sensitivity and specificity and Kappa statistics were calculated. Results. Health worker diagnosed palmar pallor with sensitivity of 30.8–42.8% and specificity of 70–89%. Similar figures for doctor were 40–47% and 60–66%, respectively. Kappa agreement between a health worker and a physician was 0.48 (95% CI = 0.298–0.666) and then increased to 0.51 when categories of severe pallor and mild pallor were merged. Conclusion. While using palmar pallor as clinical sign for anaemia, children with no pallor should also be followed up closely for possible detection of missed cases during follow-up.http://dx.doi.org/10.1155/2014/543860 |
| spellingShingle | Arun Kumar Aggarwal Jaya Prasad Tripathy Deepak Sharma Ajith Prabhu Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India Anemia |
| title | Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India |
| title_full | Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India |
| title_fullStr | Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India |
| title_full_unstemmed | Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India |
| title_short | Validity of Palmar Pallor for Diagnosis of Anemia among Children Aged 6–59 Months in North India |
| title_sort | validity of palmar pallor for diagnosis of anemia among children aged 6 59 months in north india |
| url | http://dx.doi.org/10.1155/2014/543860 |
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