Reliability Test of Different Red Blood Cell Discrimination Indices for Screening Iron Deficiency Anemia and Beta Trait Thalassemia in Pediatric Patients 6-59 Months of Age at Gema Santi Hospital, Nusa Penida, June 2023 - May 2024

Introduction: Screening for iron deficiency anemia and thalassemia beta trait in hypochromic microcytic anemia in health facilities that do not have a complete examination is quite difficult. This study aims to determine the reliability of various indices against the Green and King index including the Mentzer index which is most used for screening. The results of the study can be used to determine whether the currently used indices are reliable enough to be used for patient screening. Material and Methods: This study used a cross-sectional method with a sample of patients aged 6-59 months who came to the outpatient installation of RSUD Gema Santi Nusa Penida in June 2023 - May 2024. Various red blood cell discrimination indices that have high sensitivity and specificity such as Mentzer index, Mentzer with cut off 10.7 and Sirdah were compared with Green and King index using Cohen kappa ratio. Results: Based on the results of the analysis, Mentzer index (-0.01) is not reliable, very low reliability on the Sirdah index (0.17) and moderate reliability on the Mentzer index with a cut off 10.7 when compared to the Green and King index. Conclusions: The results stating that the Mentzer index is not reliable require further research on the sensitivity and specificity of various red blood cell indices including the Mentzer index which is often used in terms of screening to determine the best red blood cell index for use in areas with limited facilities such as the Nusa Penida region. Key words: hypochromic microcytic anemia, red blood cell discrimination index, cohen kappa ratio