Luby S P, Kazembe P N, Redd S C, Ziba C, Nwanyanwu O C, Hightower A W, Franco C, Chitsulo L, Wirima J J, Olivar M A
Epidemiology Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Bull World Health Organ. 1995;73(4):477-82.
Anaemia is a serious and common problem among young children in sub-Saharan Africa. As a first step towards developing guidelines for its recognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with anaemia. Health care workers examined a total of 1104 children under 5 years of age at two hospital-based outpatient clinics in rural Malawi. Blood samples were taken to determine haemoglobin concentrations. Pallor of the conjunctiva, tongue, palm or nail beds was 66% sensitive and 68% specific in distinguishing children with moderate a anaemia (haemoglobin concentration, 5-8 g/dl) and 93% sensitive and 57% specific in distinguishing those with severe anaemia (haemoglobin concentration, < 5 g/dl). Even without laboratory support, which is often unavailable in rural Africa, clinical findings can identify the majority of children with anaemia.
贫血是撒哈拉以南非洲地区幼儿中一个严重且常见的问题。作为制定贫血识别与治疗指南的第一步，我们开展了一项研究，以评估卫生工作者利用临床检查结果来识别贫血儿童的能力。卫生保健工作者在马拉维农村地区的两家医院门诊诊所对总共1104名5岁以下儿童进行了检查。采集血样以测定血红蛋白浓度。结膜、舌头、手掌或甲床苍白在区分中度贫血儿童（血红蛋白浓度为5 - 8克/分升）时敏感性为66%，特异性为68%；在区分重度贫血儿童（血红蛋白浓度<5克/分升）时敏感性为93%，特异性为57%。即使没有实验室支持（在非洲农村地区通常无法获得），临床检查结果也能识别出大多数贫血儿童。
