Selective screening for iron deficiency anemia would be a better option in which scenario?

• A. Communities with a historically low incidence of anemia
• B. Areas with high prevalence of anemia
• C. All infants
• D. Preterm infants only

Answer: (A)

Screening decisions hinge on how common the condition is in the population. When iron deficiency anemia is uncommon in a community, screening everyone yields few true cases and adds unnecessary costs, potential false positives, and treatment for people who don’t need it. Targeted screening—testing only those with identifiable risk factors or in high-risk groups—improves the yield and makes better use of resources. In contrast, in areas where anemia is more prevalent, broader or universal screening becomes more justified because the likelihood of finding cases is higher and the public health benefit is greater. So in a community with historically low incidence of anemia, selective screening is the most efficient approach.