Evaluating the Mentzer Index for Screening of Iron Deficiency Anemia and Beta Thalassemia Among Infants Visiting Primary Health Centers in Dubai, United Arab Emirates: A Retrospective Study

TL;DR

This study evaluates the Mentzer index's effectiveness in screening infants in Dubai for iron deficiency anemia and beta thalassemia using primary healthcare data.

Contribution

The study applies and validates the Mentzer index in a pediatric population in Dubai for anemia and thalassemia screening.

Findings

14.6% of eligible patients had iron deficiency anemia based on low ferritin levels.

10.6% of patients had β-thalassemia based on hemoglobin electrophoresis.

The Mentzer index showed 99% sensitivity but only 54.5% specificity for screening.

Abstract

Objective: The study aims to apply the Mentzer index to the population of all eligible pediatric patients presenting to primary healthcare centers (PHCs) in Dubai for the first year of life screening. Additionally, the study will estimate the prevalence of iron deficiency anemia (IDA) and β-thalassemia in children presenting to the PHCs and evaluate the importance of PHCs in screening children for IDA and β-thalassemia by comparing the results of this study to previous results.

Methods: The SALAMA system (electronic medical record system used in PHCs in Dubai) was used for collecting the data. Eligible patients’ data, such as hemoglobin, mean corpuscular volume (MCV), and red blood cell (RBC) counts were collected and recorded. The Mentzer index was applied to patients and the index results were compared to the gold standard results extracted from the SALAMA system. The gold standard diagnosis for IDA used was the serum ferritin test and the gold standard diagnosis for β-thalassemia used in the study was hemoglobin electrophoresis.

Results: Out of the 75 eligible patients with low hemoglobin, 11 (14.6%) had low ferritin indicating IDA. Moreover, eight (10.6%) patients had abnormal hemoglobin electrophoresis indicating β-thalassemia. The Mentzer index was applied to the patients; 13 (17.3%) of them had a value less than 13 (β-thalassemia) and 6 (8%) had a value more than 13 (IDA). The sensitivity of the Menzter index in screening IDA and β-thalassemia is 99% and the specificity is 54.5%.

Conclusion: Our study found that the Mentzer's index is a reliable screening tool due to its high sensitivity; however, we suggest replicating the study with a larger sample size to get more clinically significant results.

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