Assessment of iron deficiency in malnutrition: the value of serum ferritin

Background Iron deficiency is the most common micronutrient deficiency seen in protein energy malnutrition (PEM) and a common cause of morbidity and mortality in this condition. Aim The aim of the study was to assess the value of serum ferritin among PEM patients with iron deficiency. Patients and methods It was a case–control study in which the participants were children diagnosed of PEM and the controls were children with normal nutrition. Ninety participants and controls each participated in the study with informed consent obtained from caregivers. Full blood count and examination of peripheral blood smear and serum ferritin concentration was analyzed by enzyme-linked immunosorbent assay. Statistical analysis Data entry and analysis were carried out with a microcomputer using the SPSS, version 16, software packages. Results The mean age of the children with PEM was 22.7±14.4 months. In the participants, the prevalence of iron deficiency was 24.4%, while that of iron-deficiency anemia was 16.6%. The mean serum ferritin levels were significantly lower in the patients compared with controls (P=0.000). The sensitivity and specificity of serum ferritin was 100.0% (95% confidence interval). The likelihood ratio was 0.00 (95% confidence interval). Conclusion Patients with PEM were found to have high prevalence of iron-deficiency anemia and low serum ferritin levels. The sensitivity and specificity of serum ferritin levels were found to be high among PEM patients with iron-deficiency anemia.