THE EFFECTIVENESS OF THE COMBINATION OF HB, MCV, AND RDW IN SCREENING FOR ANEMIA IN MOTHERS AND CHILDREN: A CONTEXTUAL SYSTEMATIC REVIEW IN TIMOR LESTE

Abstract

Introduction: Anemia in pregnant women and children is an important global health issue, with a high prevalence in developing countries such as Timor-Leste. Early detection of anemia is crucial to reduce the risk of complications. This study aims to evaluate the effectiveness of a combination of classic hematological parameters, namely hemoglobin (Hb), mean corpuscular volume (MCV), and red cell distribution width (RDW), in detecting anemia in mothers and children in Timor-Leste, taking into account geographical, socioeconomic, and local health service capacity factors. Methods: This study used a systematic review method to analyze various studies related to the effectiveness of classic hematological parameters in detecting anemia. Data were collected from studies that tested these parameters in populations of mothers and children and compared the results with non-invasive technologies such as SpHb, Ret-He, and artificial intelligence (AI)-based applications. The study also examined the influence of geographical and socioeconomic factors on the validity of using classic hematological parameters in anemia screening. Results: The results showed that the combination of Hb, MCV, and RDW had higher sensitivity and specificity in detecting anemia in mothers and children compared to using a single parameter. MCV and RDW provide significant added value in distinguishing types of anemia, such as iron deficiency anemia and anemia due to chronic disease. SpHb and AI-based applications show good results, but both have lower sensitivity compared to the combination of classic hematology parameters, especially in certain clinical conditions. Discussion: This study confirms that the combination of Hb, MCV, and RDW is a more effective and practical approach for screening anemia in pregnant women and children, especially in Timor-Leste, with limited medical resources. The use of non-invasive technologies such as SpHb and AI applications can be complementary, but their validity depends on patient conditions and medical infrastructure. In addition, geographical factors such as altitude and socioeconomic factors such as nutritional status need to be taken into account to adjust Hb cut-offs to improve the accuracy of anemia detection.

Keywords: Anemia, Hemoglobin, MCV, RDW, Screening, Mother-Child, Non-Invasive Technology, Timor-Leste, Systematic Evaluation