Development of a Toddler Anemia Classification Tool Based on Palm Pallor
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Abstract
Background: Nutritional anemia in toddlers remains a significant public health problem in Indonesia, affecting growth, development, and immunity. Palm pallor assessment has been proposed as a simple screening method in settings with limited laboratory access. This study aimed to develop and evaluate a palm pallor-based classification tool compared with hemoglobin measurement using the cyanmethemoglobin method.
Methods: A cross-sectional study was conducted among 36 toddlers aged 6–57 months at a public health center in Bantul. Data were collected through visual assessment of palm pallor and laboratory hemoglobin measurement. Diagnostic performance was evaluated using sensitivity, specificity, false positive, and false negative rates. Bivariate analysis was performed using Fisher’s Exact Test.
Results: The sensitivity value based on the calculation of the results is 68.97%, while the specificity value is 71.43%. False positive values were obtained at 28.57%, while false negative values were at 31.03%. A statistically significant association was found between palm pallor and anemia status (p = 0.001).
Conclusion: Palm pallor assessment can be used as a simple and practical screening tool for detecting anemia in toddlers, particularly in low-resource settings. However, due to its moderate diagnostic accuracy, it should be complemented with confirmatory laboratory testing. Further studies are needed to improve its accuracy and validate its use in larger populations.
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