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Paediatrica Indonesiana

Original Article

VOLUME 54 NUMBER 5September

294 Paediatr Indones, Vol. 54, No. 5, September 2014

Mentzer index as a screening tool for iron deficiency

anemia in 6-12-year-old children

Sri Lestari S. Alam1, Rini Purnamasari1, Erial Bahar2, Kemas Ya’kub Rahadiyanto3

AbstractBackground a high prevalence of iron deficiency

Objective

diagnosing IDA by comparing Mentzer indexes to serum ferritin

Methods

examined complete blood counts to diagnose hypochromic-

microcytic anemia, calculated Mentzer indexes, and measured

Mentzer index compared to serum ferritin level for diagnosing

Results

receiver-operator curve (ROC) curve analysis, the area under the

Conclusion Mentzer index has good validity as an inexpen-

[Paediatr Indones. 2014;54:294-8.]

Keywords: IDA, Mentzer index, serum ferritin

From the Departments of Child Health, Biostatistics, and Clinical

Pathology

Reprint requests to

m

Iron deficiency anemia (IDA) is a major public

is of concern because untreated IDA may lead to

Basic Health Research Report (Riset Kesehatan

Dasar

Iron deficiency anemia (IDA) is diagnosed by

blood count (CBC), serum iron(SI), total iron binding

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Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia

Paediatr Indones, Vol. 54, No. 5, September 2014 295

the high prevalence of IDA in children, especiallyin school-aged children, early screening is needed to

affordable and sensitive enough to screen for IDA in

tests, the Mentzer index had the highest sensitivity

using the Mentzer index to screen for IDA in school-

Mentzer index to the serum ferritin level test for

hypochromic-microcytic anemia, and to define

Methods

history (pale or icteric history), severe anemia, chronic

infection (prolonged fever), inflamation diseases,

severe malnourished, and or body temperature above

Data collected included history, physical

age, gender, parental education level, socioeconomic

manifestations of anemia, infection, inflammation,

4 Blood specimens

anemia provided a second blood specimen for serum

ferritin measurements performed at a reference

linked immunosorbent assay (ELISA) using a Mini

Vidas

5

considered to be palmar and or conjunctival palpebrae

We performed validity tests (sensitivity, specific-

-

hood ratio, and accuracy) to assess the diagnostic

value of Mentzer index to screen for IDA in subjects

the statistical product and services solutions (SPSS)

version 15.0.

Results

Subject recruitment process in this study consisted of

Figure 1

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Iron status profile according to sex, age and nutritional

Table 2

revealed that the best Mentzer index value cut off point

Table 3

Discussion

Iron deficiency anemia (IDA) is common in children,

6 It can impair many

7 We aimed to find a

simple and affordable screening tool to identify IDA

practice, serum ferritin level is the reference standard

Some sensitive previously

reported screening tools are the Mentzer, erythrocyte,

Among these indexes, the Mentzer index reportedly

them had clinical manifestation of anemia, and

Table 1

6

Table 1

Characteristics %

Male

Female

52

52

Table 2

Variables

Male

Female

0.720

Table 3.

5

5

27

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Paediatr Indones, Vol. 54, No. 5, September 2014 297

Serum ferritin level is a sensitive and reliable

Normal values of serum ferritin for children aged 6

is an acute-phase reactant that can become elevatedin settings of inflammation, chronic infection and

In order to prevent false negatives for IDA us-

-

tion based on history-taking, physical examination

and performing semi-quantitative C-reactive protein

based on median value of serum ferritin level at age

5

-

et al

Gender differences reportedly only affect ID in adoles-

cents, as females are at higher risk due to menstrua-

has also been attributed to chronic blood loss due to

Serum ferritin level reportedly differ according to

ferritin level according to age groups, similar to that

Figure 1

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5

We constructed a ROC in order to choose the

In conclusion, Mentzer index is valid to use as

Mentzer index to screen for IDA in children aged

of IDA in hospitals, other tests should still used for

iron status examination and iron supplementation

Acknowledgments

We thank all the participating parents, children, teachers,

to the laboratory staff of Muhamadiyah Hospital and Balai Besar

Laboratorium Kesehatan in Palembang

References

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s

Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B,

th

JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B,

th

st

thalassemia minor and iron deficiency anemia by screening

st

st

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