USING CLINICAL SIGNS TO DIAGNOSE ANEMIA IN AFRICAN CHILDREN

Anaemia is a serious and common problem among young children in sub-Sa haran Africa. As a first step towards developing guidelines for its re cognition and treatment, we conducted a study to evaluate the ability of health workers to use clinical findings to identify children with a naemia. Health care workers examined a fetal 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. Pal lor of the conjunctiva, tongue, palm or nail beds was 66% sensitive an d 68% specific in distinguishing children with moderate anaemia (haemo globin 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 i n rural Africa, clinical findings can identify the majority of childre n with anaemia.