Palm-plantar pallor as a diagnostic method of mild-moderate anemia

Abstract

Objective: to determine the palm-plant paleness’ characteristics in Colombian infant rural population, as a diagnostic method of anemia, and to establish a correlation between the finding of palm-plant paleness and the Hematocrit values. Methodology: a cross sectional study was used to evaluate 169 boys and girls, between 2 months and 12 years old, of the rural area of San Vicente del Caguan, who entered into a Health Campaign. Following the signature of an informed consent, parents accept their children to participate in the study. Those with acute or chronic pathologies were excluded. The presence of palm-plant paleness was determined by observers trained in the Integrated Management of Childhood Illness (IMCI) Strategy. Hematocrit was measured to all children, as well as a peripheral blood smear. Interrater concordance evaluation (Kappa index) was determined through a pilot test and a validation (sensitivity, specificity) was performed, using Hematocrit as the standard. Results: 93 of the participants were male and 77 were female. 45% of them had palm paleness. The Hematocrit showed anemia in 34.1% of the children. The validation analysis demonstrated a 67.2% of sensibility, a 66.6% of specificity, a 51.3% of positive predictive values and a 79.5% of negative predictive values. Hypochromic and Eosinophilia were found in most of the peripheral blood smears’ children with anemia. Conclusions: although this tool presents a low sensibility and specificity for low/moderated anemia, it is useful for excluding it in infants without palm paleness.