A Simple Clinical Criteria for Diagnosing Severe or Moderate Anemia in Adolescent Girls in Community Settings Where Hemoglobin Testing Is Not Readily Available

Hanimi Reddy Modugu, IntraHealth International, Inc.

In India, the problem of anemia is huge, particularly among adolescent girls/women. Using Hb<10.0 g/dl as ‘gold standard’ and ‘clinical signs/symptoms’ as predictors - we have developed simple clinical-criterion for use in rural/tribal areas to identify an adolescent girl with the risk of moderate/severe anemia. Among the 4,465 adolescent girls covered: 65% were anemic (45% mild, 18% moderate, and 2% severe). Presence of any one or more of the five core-signs (dizziness, breathlessness, pallor of skin, sores in mouth, feel unconscious) gave a sensitivity of 51%, specificity of 60%, with 43% yield - to predict moderate/severe anemia. Addition of ‘fever with cough’ to core-signs improved sensitivity to 55%, specificity to 56%. Our criterion identified 46% as suspected cases of severe/moderate anemia, instead of 20%. In settings where hemoglobin testing is not feasible, diagnosing moderate/severe anemia using our criterion would be a modest, but an important first step, towards anemia management.