Assuntos
Estatura , Pré-Escolar , Creatinina/sangue , Diagnóstico Diferencial , Diagnóstico Precoce , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/etiologia , Humanos , Hipertensão/etiologia , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Testes de Função Renal , Palidez/diagnóstico , Palidez/etiologia , Diálise Renal/métodos , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Medição de RiscoRESUMO
BACKGROUND & OBJECTIVE: Anaemia is a public health problem in India, particularly in women and children. Clinical diagnosis by health workers may be inaccurate. It is therefore important to evaluate simple methods for diagnosis of anaemia in rural set up with no or minimal laboratory facilities. We carried out this study to evaluate the performance of haemoglobin colour scale and palmar pallor against filter paper cyanmethaemoglobin method as screening methods for anaemia in children 6-35 months of age. METHODS: A total of 772 children between 6-35 months were studied from three primary health centres of Wardha district, central India, by house-to-house visit. The child was examined for presence of palmar pallor and haemoglobin estimated by haemoglobin colour scale (HCS) and filter paper cyanmethaemoglobin method independently by two persons. RESULTS: Haemoglobin colour scale had sensitivity of 89 per cent and specificity of 97 per cent in detecting anaemia in children. Pallor had sensitivity of 73 per cent and specificity of 98 per cent. The predictive values were 99 per cent and 69 per cent for positive and negative HCS result. Similarly, the predictive values were 99 and 48 per cent for positive and negative pallor result. Correct diagnosis of anaemia was 34 and 0.1 times common if HCS test result was positive (Hb < 110.0 g/l) and negative (Hb > 110.0 g/l) for anaemia. INTERPRETATION & CONCLUSION: HCS fulfills the requirement of field test for screening of anaemia in resource poor country. It also has acceptable precision and accuracy and hence can be used in national anaemia control programmes.
Assuntos
Anemia/diagnóstico , Pré-Escolar , Cor , Feminino , Hemoglobinas , Humanos , Índia/epidemiologia , Lactente , Masculino , Programas de Rastreamento/métodos , Morbidade , Palidez/diagnóstico , Atenção Primária à Saúde , Reprodutibilidade dos Testes , População Rural/estatística & dados numéricos , Sensibilidade e Especificidade , Organização Mundial da SaúdeRESUMO
Las anemias hemolíticas autoinmunitarias se caracterizan por la presencia de inmunoglobulinas en la superficie eritrocitaria dirigidas contra los determinantes antigénicos de los hematíes. La anemia hemolítica autoinmune por anticuerpos calientes se caracteriza porque los autoanticuerpos actúan a la temperatura del organismo (37°C), son de clase IgG y la hemólisis es predominantemente extravascular, siendo el tipo más frecuente de anemia hemolítica autoinmune en los niños de 2-12 años de edad. Sus manifestaciones clínicas son postración, palidez, ictericia, fiebre y hemoglobinuria. El diagnóstico de las AHAI se establece con la prueba de Coombs. La administración de corticoesteroides constituye el tratamiento inicial de elección. Se presenta el caso de una preescolar femenina de tres años de edad procedente del medio rural, quien exhibe las características clínicas, paraclínica y epidemiológicas de anemia hemolítica autoinmune por anticuerpos calientes, con respuesta satisfactoria a la terapia con esteroides.