Paediatrica Indonesiana

VOLUME 54

September 

NUMBER 5

Original Article

Mentzer index as a screening tool for iron deficiency

anemia in 6-12-year-old children
Sri Lestari S. Alam1, Rini Purnamasari1, Erial Bahar2, Kemas Yakub Rahadiyanto3

Abstract
Background 7KHUH LV a high prevalence of iron deficiency
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Objective 7R DVVHVV WKH YDOLGLW\ RI WKH 0HQW]HU LQGH[ IRU
diagnosing IDA by comparing Mentzer indexes to serum ferritin
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Methods 7KH VWXG\ ZDV D GLDJQRVWLF WHVW ZLWK FURVVVHFWLRQDO
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ZHUHDJHG\HDUVZLWKK\SRFKURPLFPLFURF\WLFDQHPLD:H
examined complete blood counts to diagnose hypochromicmicrocytic anemia, calculated Mentzer indexes, and measured
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Mentzer index compared to serum ferritin level for diagnosing
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Results 7KHUHZHUHFKLOGUHQLQRXUVWXG\FRQVLVWLQJRI
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receiver-operator curve (ROC) curve analysis, the area under the
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Conclusion Mentzer index has good validity as an inexpenVLYH DQG VLPSOH VFUHHQ IRU ,'$ LQ \HDUROG FKLOGUHQ ZLWK
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[Paediatr Indones. 2014;54:294-8.]
Keywords: IDA, Mentzer index, serum ferritin

294Paediatr Indones, Vol. 54, No. 5, September 2014

ron deficiency anemia (IDA) is a major public

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is of concern because untreated IDA may lead to
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 Basic Health Research Report (Riset Kesehatan
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Iron deficiency anemia (IDA) is diagnosed by
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blood count (CBC), serum iron (SI), total iron binding
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From the Departments of Child Health, Biostatistics, and Clinical

Pathology 8QLYHUVLW\ RI 6ULZLMD\D 0HGLFDO 6FKRRO'U 0RK +RHVLQ
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Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia

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the high prevalence of IDA in children, especially
in school-aged children, early screening is needed to
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affordable and sensitive enough to screen for IDA in
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tests, the Mentzer index had the highest sensitivity
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using the Mentzer index to screen for IDA in schoolDJHGFKLOGUHQLQ3DOHPEDQJ
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Mentzer index to the serum ferritin level test for
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hypochromic-microcytic anemia, and to define
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Methods
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history (pale or icteric history), severe anemia, chronic
infection (prolonged fever), inflamation diseases,
severe malnourished, and or body temperature above
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Data collected included history, physical
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age, gender, parental education level, socioeconomic

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manifestations of anemia, infection, inflammation,
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anemia provided a second blood specimen for serum
ferritin measurements performed at a reference
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linked immunosorbent assay (ELISA) using a Mini
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considered to be palmar and or conjunctival palpebrae
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We performed validity tests (sensitivity, specificLW\SRVLWLYHSUHGLFWLYHYDOXH339QHJDWLYHSUHGLFWLYH
YDOXH139SRVLWLYHOLNHOLKRRGUDWLRQHJDWLYHOLNHOLhood ratio, and accuracy) to assess the diagnostic
value of Mentzer index to screen for IDA in subjects
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Results
Subject recruitment process in this study consisted of
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Paediatr Indones, Vol. 54, No. 5, September 2014295

Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia

them had clinical manifestation of anemia, and

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Table 1$CUGNKPGEJCTCEVGTKUVKEUQHUWDLGEVU
Characteristics
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Iron status profile according to sex, age and nutritional

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revealed that the best Mentzer index value cut off point
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Discussion
Iron deficiency anemia (IDA) is common in children,
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WKHIXQFWLRQRIPXOWLSOHRUJDQV7 We aimed to find a
simple and affordable screening tool to identify IDA
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practice, serum ferritin level is the reference standard
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reported screening tools are the Mentzer, erythrocyte,
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Among these indexes, the Mentzer index reportedly

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5GTWOHGTTKVKP
Variables
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Male
Female
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296Paediatr Indones, Vol. 54, No. 5, September 2014

Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia

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Normal values of serum ferritin for children aged 6
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based on median value of serum ferritin level at age
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Gender differences reportedly only affect ID in adolescents, as females are at higher risk due to menstruaWLRQ DQG UDSLG JURZWK ,Q GHYHORSLQJ FRXQWULHV ,'
has also been attributed to chronic blood loss due to
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Serum ferritin level reportedly differ according to
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ferritin level according to age groups, similar to that
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Paediatr Indones, Vol. 54, No. 5, September 2014297

Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia

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We constructed a ROC in order to choose the
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In conclusion, Mentzer index is valid to use as
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Mentzer index to screen for IDA in children aged
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of IDA in hospitals, other tests should still used for
iron status examination and iron supplementation
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Acknowledgments

We thank all the participating parents, children, teachers,
SHGLDWULFLDQV DQG ODERUDWRU\ WHFKQLFLDQV 7KH IROORZLQJ
SHGLDWULFLDQV FRQWULEXWHG WR WKLV VWXG\ 'LDQ 3XVSLWD 6DUL
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)LWUL\DQDDOVRDVVLVWHGZLWKWKLVVWXG\:HDOVRH[WHQGRXUWKDQNV
to the laboratory staff of Muhamadiyah Hospital and Balai Besar
Laboratorium Kesehatan in Palembang






References
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298Paediatr Indones, Vol. 54, No. 5, September 2014




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