ABSTRACT
Introduction: Anemia is one of the most commonlyencountered hematologic disease of infancy and childhood.More than 75% of Indian children under 36 months of age arefound to be anemic. Iron-deficiency anemia (IDA) has beenfound to be correlated with decreased cognitive performancein many studies, hence prompt diagnosis and treatment arenecessary. Pallor is a clinical sign in the diagnosis of anemia.Current research aimed to study about the predictive value ofpallor in various sites and its relation to anemia.Material and methods: 500 children attending the outpatientdepartment of pediatrics were evaluated for clinical pallor andHemoglobin was estomated by cyanmethemoglobin method.Results: When the various parameters were comparedbetween conjunctival, palmar, mucosal and nail bed pallor;it has been observed that sensitivity was highest for nail bedpallor in the evaluation of anemia. Specificity was highest forconjunctival pallor. The positive predictive value and negativepredictive value were both highest for conjunctival pallorand least for palmar pallor. However, when all the evaluatedparameters were compared in patients with severe anemia,highest sensitivity and specificity was observed for palmarpallor. The positive predictive value was highest for palmarpallor and least for nail bed pallor. The negative predictivevalue was highest for conjunctival pallor and least for nail bedpallor.Conclusion: Clinical pallor of the nailbeds had highestsensitivity for detection of moderate anemia while palmarpallor had the highest sensitivity for the detection of severeanemia. These are simple clinical signs which can be read evenby non doctors and can thus be taught to various personnellike health workers and school teachers for early detection andprompt management of anemia in children below 5 years.