Indicators for assessment of anemia and iron deficiency in community

REVIEW ARTICLE

Indicators for Assessment of Anemia and Iron Deficiency in Community

K N Agarwal.

Indian National Science Academy & Health Care & Research Association for Adolescents.

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Abstract
The review discusses problem of nutritional anemia, particularly iron deficiency with or without anemia. Critical analysis continues to recommend cyanmethemoglobin method for estimation of hemoglobin; filter paper technique is suited for field surveys. Recently introduced HemoCue method for hemoglobin estimation is practical. However, variability in hemoglobin estimation as compared to cyanmethemoglobin need be evaluated in selected laboratories of the country to derive some form of conversion factor. The red cell indices especially mean corpuscular volume (MCV), percentage mature hypochromic erythrocytes (HyPom), red cell distribution width (RDW) and reticulocyte changes- hemoglobin concentration(CHr) and size(Ret Y), in institutions with modern automated analyzer are of interest as these are more sensitive indices than the hemoglobin level.

Serum iron, total iron binding capacity and transferrin saturation are not good indicators of iron status. Serum ferritin represents body iron stores; in infection free situation, it is an ideal indicator for diagnosis of iron deficiency and response to iron therapy in community. Recent studies suggest estimation of serum transferrin receptors in addition to serum ferritin in diagnosis of iron deficiency. Bone marrow iron assessment is useful in individual patient; it is not affected by infection. For country like ours, with high prevalence and severity of anemia, hemoglobin estimation, peripheral smear to exclude malaria and response to iron therapy remain important time tested tools to diagnose iron deficiency.

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