Field trial of a haemoglobin colour scale: an effective tool to detect anaemia in preschool children

The objective of this study was to evaluate the performance of the Haemoglo bin Colour Scale, developed by Stott and Lewis, to diagnose anaemia in a pr imary health care setting where anaemia was prevalent and severe. Three mea sures of anaemia were compared in 535 preschool children: haemoglobin based on the Haemoglobin Colour Scale, clinical assessment in three sites (conju nctiva, palm and nail bed) and haemoglobin based on a digital haemoglobinom eter (HemoCue method) taken as gold standard. A statistically significant c orrelation (r = 0.80, coefficient = 0.77 and Y intercept = 2.33) was obtain ed between the results of the Haemoglobin Colour Scale and the HemoCue. In more than 80% of cases, the difference between the colour scale readings an d the results of the HemoCue was within 1 g/dl. Of 415 anaemic children (Hb < 11 g/dl by HemoCue), 85.2% were so identified by the Haemoglobin Colour Scale and 19.7% were classified anaemic by clinical pallor. Of 19 severely anaemic children (Hb < 7 g/dl by HemoCue), 73.6% were identified as severel y anaemic and 100% were classified as anaemic by the colour scale, 61.1% we re classified as anaemic using clinical pallor. We found the Haemoglobin Co lour Scare to be a useful tool in identifying anaemic and severely anaemic children. Efficiencies in term of cost, accuracy and rime make it an import ant resource in primary health care settings in developing countries. Furth er testing with other staff in other settings is recommended to determine t he usefulness of large-scale distribution.