Peer-reviewed article
BEYOND HEMOGLOBIN: RISK-BASED AND NONINVASIVE SCREENING TO ENHANCE EARLY DETECTION OF IRON DEFICIENCY AMONG CHILDREN IN INDONESIA
Mardatillah, Fadhillah M. Rajab, Rachel Amanda ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This narrative review looks at ways to detect iron deficiency anemia in young children in Indonesia without relying only on hemoglobin tests. It draws on observational studies indexed in Scopus from 2019 to 2026. The authors report that where invasive lab tests are hard to access, validated risk-based screening tools and non-invasive methods may help identify children at risk. They suggest adding a practical risk-based screening tool to routine child growth monitoring so that children can be referred for confirmatory testing and treated earlier.
Key points
- Iron deficiency anemia is the most common micronutrient deficiency globally and a major concern for children under five in low- and middle-income countries.
- Where invasive laboratory tests are limited, validated risk-based and non-invasive methods may improve identification of children at risk.
- These approaches may give a more accurate estimate of disease burden.
- They may also improve understanding of the cognitive implications and nutritional determinants of iron deficiency.
- A risk-based screening tool could be built into routine growth monitoring and Indonesia's existing child nutrition and growth promotion programs.
Limitations
This is a narrative review of observational studies, and the abstract gives no number of studies, effect sizes or accuracy figures for the screening tools. It cannot show that the screening approach improves child health outcomes.
Abstract
Background: Iron deficiency anemia (IDA) remains the most common micronutrient deficiency globally and continues to represent a major public health concern among children younger than five years, particularly in low- and middle-income countries. Early identification of children at risk is essential to prevent adverse effects on growth, neurodevelopment, and long-term health outcomes. Methods: A narrative review was undertaken to synthesize evidence from observational studies indexed in Scopus and published between 2019 and 2026. The review focused on studies evaluating screening approaches beyond conventional hemoglobin measurement, with particular emphasis on risk-based and non-invasive strategies for improving the early detection of IDA among Indonesian children. Results: The available evidence indicates that, in settings where access to invasive laboratory investigations is constrained, validated risk-based screening instruments and non-invasive assessment methods may improve the identification of children at risk for IDA. These approaches contribute not only to more accurate estimation of disease burden but also to a broader understanding of the cognitive implications and nutritional determinants of iron deficiency, extending beyond reliance on biomarker-defined diagnostic thresholds. Conclusion: Incorporating a practical risk-based IDA screening tool into routine child growth monitoring has the potential to enhance the early identification of vulnerable children, facilitate appropriate referral for confirmatory testing and timely intervention, and support the integration of anemia prevention within Indonesia's existing child nutrition and growth promotion programs.