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 Ya’kub Rahadiyanto3

Abstract ron deficiency anemia (IDA) is a major public

Background 7KHUH LV a high prevalence of iron deficiency
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JURZWK DQG GHYHORSPHQW SURFHVV LQ FKLOGUHQ 7KH UHIHUHQFH
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I KHDOWKSUREOHPLQ,QGRQHVLD7KHKLJKSUHYDOHQFH
is of concern because untreated IDA may lead to
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 Basic Health Research Report (Riset Kesehatan
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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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VHQVLWLYLW\DQGVSHFLILFLW\
Methods 7KH VWXG\ ZDV D GLDJQRVWLF WHVW ZLWK FURVVVHFWLRQDO
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ZHUHDJHG\HDUVZLWKK\SRFKURPLFPLFURF\WLFDQHPLD:H
examined complete blood counts to diagnose hypochromic-
microcytic anemia, calculated Mentzer indexes, and measured
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Mentzer index compared to serum ferritin level for diagnosing
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Iron deficiency anemia (IDA) is diagnosed by
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UHYHDOV PLFURF\WLF DQGRU K\SRFKURPLF UHG EORRG
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,'$
Results 7KHUHZHUHFKLOGUHQLQRXUVWXG\FRQVLVWLQJRI GLDJQRVWLF WHVWV ZLGHO\ XVHG IRU ,'$ DUH FRPSOHWH
ER\VDQGJLUOVZLWKDPHDQDJHRI6'\HDUV)URPWKH blood count (CBC), serum iron (SI), total iron binding
receiver-operator curve (ROC) curve analysis, the area under the FDSDFLW\7,%&DQGVHUXPIHUULWLQOHYHO
FXUYH$8&ZDVIRUD0HQW]HULQGH[FXWRIISRLQWRI
'LDJQRVWLFWHVWDQDO\VLVUHYHDOHGDVHQVLWLYLW\RIVSHFLILFLW\
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Conclusion Mentzer index has good validity as an inexpen-
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[Paediatr Indones. 2014;54:294-8.]
Keywords: IDA, Mentzer index, serum ferritin
From the Departments of Child Health, Biostatistics, and Clinical
Pathology 8QLYHUVLW\ RI 6ULZLMD\D 0HGLFDO 6FKRRO'U 0RK +RHVLQ
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Reprint requests to6UL/HVWDUL6$ODP'HSDUWPHQWRI&KLOG+HDOWK
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294‡Paediatr 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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DQG QRW ZLGHO\ DYDLODEOH LQ ,QGRQHVLD %HFDXVH RI manifestations of anemia, infection, inflammation,
the high prevalence of IDA in children, especially DVZHOODVDQWKURSRPHWULFPHDVXUHPHQWVFRPSULVLQJ
in school-aged children, early screening is needed to RIZHLJKWNJDQGKHLJKWFP%DVHGRQ&'&
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affordable and sensitive enough to screen for IDA in ZHLJKWIRUKHLJKWLQGH[RUXQGHUQRXULVKHG
VFKRRODJHG FKLOGUHQ 7HVWV SUHYLRXVO\ VKRZQ WR EH ZHLJKWIRUKHLJKWLQGH[•4 Blood specimens
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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 school-
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Mentzer index to the serum ferritin level test for
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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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hypochromic-microcytic anemia, and to define
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Methods
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considered to be palmar and or conjunctival palpebrae
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We performed validity tests (sensitivity, specific-
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hood ratio, and accuracy) to assess the diagnostic
value of Mentzer index to screen for IDA in subjects
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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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Results
Subject recruitment process in this study consisted of
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Paediatr Indones, Vol. 54, No. 5, September 2014‡295

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

them had clinical manifestation of anemia, and 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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Table 1$CUGNKPGEJCTCEVGTKUVKEUQHUWDLGEVU
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Characteristics P
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#IGITQWR practice, serum ferritin level is the reference standard
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296‡Paediatr 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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based on median value of serum ferritin level at age
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Normal values of serum ferritin for children aged 6
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is an acute-phase reactant that can become elevated
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tion based on history-taking, physical examination
and performing semi-quantitative C-reactive protein
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Gender differences reportedly only affect ID in adoles-
cents, as females are at higher risk due to menstrua-
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has also been attributed to chronic blood loss due to
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Paediatr Indones, Vol. 54, No. 5, September 2014‡297

 Sri L. S. Alam et al: Mentzer index as a screening tool for iron deficiency anemia
VHUXPIHUULWLQLQFKLOGUHQDJHGPRQWKV\HDUV5
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,
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SHGLDWULFLDQV FRQWULEXWHG WR WKLV VWXG\ 'LDQ 3XVSLWD 6DUL
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to the laboratory staff of Muhamadiyah Hospital and Balai Besar
Laboratorium Kesehatan in Palembang
References
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