Background

Focus in anemia control has been restricted to tackling Iron deficiency Anemia (IDA), through supplementation alone. Is it enough? So, perhaps we need to first correctly identify anemia (Using point of care testing devices (POCT)), secondly treat its cause (Using algorithmic approach). This may change the game in anemia control.

Materials and methods

We recruited 450 males & females between 10-19y, & 20-60y each (N=1800) using cluster and PPS sampling strategy from a rural community in Eastern India. Hemocue (HC) 201 and 301 (Index test) were compared with SYSMEX-XP100 (reference test) for anemia detection. Blood cell indices, stool examination, Se ferritin, Peripheral smear etc. were used in an algorithmic fashion to delineate the spectrum of anemia.

Results

Index test overestimated prevalence. Accuracy parameters determined these estimates. Interestingly accuracy statistics varied with prevalence of disease. Clinically, chance of missing anemia cases with Hb around the cut-offs was higher with HC 301 as against HC 201. Overall 2/3rds of anemia were due to IDA, 6.37% had thalassemia, <2% had megaloblastic anemia etc.

Conclusions

Treating the cause might lead to faster decline in prevalence. POCTs to be judiciously used keeping in view errors in disease burden estimates and clinical classification of subjects.