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Iron is often initiated for children with low hemoglobin values in the absence of other indicators of iron deficiency in low-resource settings. Unfortunately, there are few reports describing outcomes from such an approach outside of clinical trials. This study examined outcomes of an anemia screening and treatment service in a low-resource community in the Dominican Republic. Complete blood counts (CBC) and receipt of iron supplementation were extracted from health records of young children participating in a well-baby clinic in the targeted community. Of the 265 children screened, 68.7% had hemoglobin values <11.0 g/dl; 61.5% of these anemic children had follow-up CBCs. While 72.3% of those with follow-up CBCs picked-up some iron supplements, only 21.4% had a follow-up hemoglobin ≥11.0 g/dl. Amount of iron given was not related to change in hemoglobin at follow-up. More follow-up monitoring of quality and impact of community care is required with associated evidence-informed benchmark targets. [ABSTRACT FROM AUTHOR]

Response to anemia in low-resource settings may entail presumptive iron treatment for those with Hemoglobin (Hb) levels falling below certain cut points. This study aimed to inform an anemia screening and treatment service in a low-income community in the Dominican Republic by determining (i) the prevalence of anemia in young children attending this service using different Hb cut points and (ii) the extent of microcytosis using different recommended cut points for the mean corpuscular volume (MCV). Using the WHO recommended cut point of <11.0 g/dl, 69.9% of 292 children would be classified as anemic, while using a more conservative cut point, <10.0 g/dl, 34.6% would be identified. Depending on the Hb cut point and which of two age-based MCV cut points are used, the prevalence of microcytosis within the anemic subsamples ranged from 23.5% to 80.2%. With increasing availability of complete blood counts in low resource settings (vs. Hb only), more sophisticated management algorithms are necessary to guide primary care efforts., (© The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)