Table 2 Summary of existing recommendations
From: Screening of iron deficiency anaemia in early childhood
Source | Ref | Date | General recommendations for anaemia by iron deficiency screening |
|---|---|---|---|
WHO | [3] | 2001 | For countries with adequate resource conditions, screening with haemoglobin or haematocrit and additional tests (serum ferritin or transferrin saturation) is recommended. |
USPSTF | [7] | 2015 | ‘The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency anemia in children ages 6 to 24 months.’ (I statement) |
‘This recommendation applies to children ages 6 to 24 months living in the United States who are asymptomatic for iron deficiency anemia. It does not apply to children younger than age 6 months or older than 24 months, children who are severely malnourished, children who were born prematurely or with low birth weight, or children who have symptoms of iron deficiency anemia.’ | |||
PrevInfad | [1] | 2011 | • Universal screening: it is recommended NOT to screen IDA (Low quality of the evidence, strong recommendation) |
• Screening in high-risk groups: IDA screening is recommended in all preterm infants under 1500 g of weight. ‘The benefits of routine screening, once the prophylaxis for IDA in asymptomatic premature children under 1500 g or less than 32 weeks is over, is greater than the potential damage.’ There is no evidence to recommend a second screening among children with risk factors who had a normal first screening. (Low quality evidence, weak recommendation) | |||
CDC | [10] | 1998 | • Universal screening: “In populations of infants and preschool children at high risk for iron-deficiency anemia (e.g., children from low-income families, children eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children, migrant children, or recently arrived refugee children), screen all children for anemia between ages 9 and 12 months, 6 months later, and annually from ages 2 to 5 years.” |
• Selective screening: “In populations of infants and preschool children not at high risk for iron-deficiency anemia, screen only those children who have known risk factors for the condition: | |||
° Consider anemia screening before age 6 months for preterm infants and low-birth weight infants who are not fed iron-fortified infant formula. ° Annually assess children aged 2–5 years for risk factors for iron-deficiency anemia (e.g., a low-iron diet, limited access to food because of poverty or neglect, or special health-care needs). Screen these children if they have any of these risk factors. ° At ages 9–12 months and 6 months later (at ages 15–18 months), assess infants and young children for risk factors for anemia […].” | |||
UK NSC | [11] | 2017 | • “A systematic population screening programme for iron deficiency anaemia in children under 5 is not recommended.” |
AAP | [13] | 2010 | • Universal screening: recommended at approximately 1 year of age with determination of haemoglobin concentration and an assessment of risk factors associated with ID or IDA. |
• Selective screening: recommended at any age in children who are at increased risk for ID or IDA. | |||
• If haemoglobin < 11 g/dL or if high risk of dietary ID, additional screening tests for evaluating ID/IDA with serum ferritin and C-reactive protein, or reticulocyte haemoglobin. | |||
• If mild anaemia (haemoglobin between 10 and 11 g/dL), close monitoring and document a 1 g/dL increase in plasma Hb concentration after 1 month of appropriate iron-replacement therapy. |