World health organization hemoglobin cut-off points for the detection of anemia are valid for an Indonesian population

The study was designed to determine whether population-specific hemoglobin cut-off values for detection of iron deficiency are needed for Indonesia by comparing the hemoglobin distribution of healthy young Indonesians with th at of an American population. This was a cross-sectional study in 203 males and 170 females recruited through a convenience sampling procedure. Hemogl obin, iron biochemistry tests and key infection indicators that can influen ce iron metabolism were analyzed. The hemoglobin distributions, based on in dividuals without evidence of clear iron deficiency and infectious process, were compared with the National Health and Nutrition Survey (NHANES) II po pulation of the United States. Twenty percent of the Indonesian females had iron deficiency, but no male subjects were iron deficient. The mean hemogl obin of Indonesian males was similar to the American reference population a t 152 g/L with comparable hemoglobin distribution. The mean hemoglobin of t he Indonesian females was 2 g/L lower than that of the American reference p opulation, which may be the result of incomplete exclusion-of subjects with milder form of iron deficiency. When the WHO cutoff (Hb < 120 g/L) was app lied to female subjects, the sensitivity of 34.2% and specificity of 89.4% were more comparable to the test performance for white American women, in c ontrast to those of the:lower cut-off. On the basis of the finding of hemog lobin distribution of men and the test performance of anemia (Hb < 120 g/L) for detecting iron deficiency for women:, it is concluded that there is no need to develop different cut-off points for anemia as a tool for iron-def iciency screening in this population.