• S P Luby, P N Kazembe, S C Redd, C Ziba, O C Nwanyanwu, A W Hightower, C Franco, L Chitsulo, J J Wirima, and M A Olivar.
• Epidemiology Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
• Bull. World Health Organ. 1995 Jan 1; 73 (4): 477-82.

AbstractAnaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of the conjunctiva, tongue, palm or nail beds was 66% sensitive and 68% specific in distinguishing children with moderate a anaemia (haemoglobin concentration, 5-8 g/dl) and 93% sensitive and 57% specific in distinguishing those with severe anaemia (haemoglobin concentration, < 5 g/dl). Even without laboratory support, which is often unavailable in rural Africa, clinical findings can identify the majority of children with anaemia.

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