Detection Of Anemia

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 that of an American population. This was a

cross-sectional study in 203 males and 170 females recruited through a convenience

sampling procedure. Hemoglobin, iron biochemistry tests and key infection indicators that

can influence iron metabolism were analyzed. The hemoglobin distributions, based on

individuals without evidence of clear iron deficiency and infectious process, were compared

with the National Health and Nutrition Survey (NHANES) II population of the United States.

Twenty percent of the Indonesian females had iron deficiency, but no male subjects were

iron deficient. The mean hemoglobin of Indonesian males was similar to the American

reference population at 152 g/L with comparable hemoglobin distribution. The mean

hemoglobin of the Indonesian females was 2 g/L lower than that of the American reference

population, 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 applied 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 contrast to those of the lower cut-off. On the basis of the

finding of hemoglobin 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-deficiency screening in this population.

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