VALIDASI KLASIFIKASI ANEMIA PADA BALITA DENGAN MELIHAT KEPUCATAN TELAPAK TANGAN

Abstract

Childhood Anemia is a major public health problem in Indonesia. Because of lack of laboratory facilities, most of primary health facilities have to rely on physical signs and not laboratory tests to detect anaemic patients who need therapy. The objective of this study was to assess the validity of palmar pallor as diagnosis of anaemia. This study identified anaemia in primary health center by two physicians and two health workers. The samples were children with illnes (6 months < 60 months) who came to primary health center. Each sample was examined by two physicians and two health workers by measuring Hemoglobine concentration using by Cyantmeth method. A total of 123 samples were examined: 65 males (52.8%), 58 females (47.2%), The mean of age was 26 months, whereby the youngest was 6 months and the oldest was 59 months. The mean Haemoglobine level among these children was 10.6 g/dl. The minimum concentration of Hb was 4.7 g/dl and the maximum was 14.6 g/dl. The children who were categorized having some palmar pallor and severe palmar pallor were compared to no pallor for hemoglobin level < 11 g/dl had sensitivity 45.7% by physicians, and 52.85% by health workers, Specificity 73.58% by physicians and 68.84% by health workers, Likelihood ratio (+)1.8 by physicians and health workers. Children categorized combination some palmar pallor and no palmar pallor were compared to severe pallor for hemoglobin level < 5 g/dl had sensitivity 100% by physicians and health workers, Spesifisity 95.22% by physicians and 95.49% by health workers, Likelihood ratio (+) 41.45 by physicians and 38.39 by health workers. The inter-rater agreement between the study physician once and the other physician for the detection palmar pallor (severe, some, or none) were K =0.49 (moderate). The inter­ rater agreement between the study health worker once and the other health worker for the detection palmar pallor (severe, some, or none) were K =0.45 (moderate). The inter-rater agreement between the study physician and health worker for the detection palmar pallor (severe, some, or none) were K =0.32(/air) to 0.55 (moderate). The study demonstrated that clinical criteria (severe pallor) could be used to identify children with severe anaemia. Clinical criteria (combination some pallor and severe pallor) can be used to identify children with anaemia but had sensitivity 50% only. Kata Kunci: Palmar pallor-anaemia-children-validitas.