Content Hemoglobin Reticulocyte (CHr) Untuk Skrining Defisiensi Besi Pada Anak Usia 6 bulan-5 Tahun

Anemia is a major health problem around the world and iron deficiency is the major cause. In children under 5 years iron deficiency will cause disruption in their growth and development. For that reasons iron deficiency in children should be detected as early as possible. . Gold standard for the detection of iron deficiency is hemosiderin examination from bone marrow aspiration, but this examination are invasive and difficult to implement. Ferritin is often used to detect iron deficiency but it has various limitations. Reticulocyte hemoglobin content (CHr) was introduced as a new parameter for the identification of iron deficiency. This parameter measures the levels of hemoglobin in the reticulocytes which is newly released from bone marrow and expected to reflect the actual conditions in the bone marrow so it can detect early iron deficiency. It is hoped that CHr can identify iron deficiency with more cheaper, easy, and applicative method. The aims of this study are to determine the diagnostic performance of CHr in screening of iron deficiency in children aged 6 months to 5 years. This study is a cross sectional study to determine the diagnostic performance of CHr and use ferritin as gold standard. The subjects of this study were healthy children aged 6 months-5 years taken from Posyandu in Yogyakarta district and has obtained the consent of their parent/guardian. CHr examination using flowcytometry method by Advia 120 Hematology Analyzer. Ferritin examination using electrochemiluminescens methods with Elecsys 1010. ROC curve analysis performed using SPSS version 17. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and likelihood ratio was calculated with a 2x2 table. Youden�s index was used to choose the proper cutoff level of CHr for diagnosing iron deficiency The study was conducted on 104 subjects. Cutoff level of CHr was �27.55 pg and sensitivity, specificity, diagnostic accuracy, positive and negative predictive value are 91.7%, 78.3%, 79.8%, 35.4%, 98.63% respectively. Likelihood ratios positive and negative results are 4.21 and 0.1. CHr is expected to be use to screen iron deficiency in children under 5 years ol