Performance Evaluation of the Pallor in the Diagnosis of Anemia


Aleefia Khurshid
Soni Chaturvedi
Boudjelal Meftah


With minimal resources and trained labour, digital image processing techniques can be used for diagnostic support system in illness identification at an early stage. These methods can also aid doctors during clinical evaluations by removing the need for invasive pathological investigations. By just viewing the colour content of the image of the pallor site, various blood components such as hemoglobin and billirubin can be analysed and classed in terms of the colour properties of the image. This research effort is an attempt to propose an image based method of quantifying hemoglobin(Hb) by examining the brightness, red component and texture of the patient's palpebral conjunctiva image after image super resolution. According to WHO recommendations, a computational model based on network of neurons is employed to relate the hemoglobin level to be measured with the level measured by the conventional invasive technique. Furthermore, based on the models’ testing results, patients with Hb concentrations below 11g/dL were identified as anemic. The predicted categorization findings were then compared to the actual Hb value acquired from an invasive test using a confusion matrix. The proposed algorithm is shown to have a sensitivity of 91 percent and a specificity of 99 percent in diagnosing anemia. The proposed approach is useful not only for detecting severe but moderate anemia too and will be valuable in assisting medical practitioners in making accurate anemia diagnosis in clinics with limited available resources for healthcare using non invasive procedure.


How to Cite
Khurshid, A., Chaturvedi, S., & Meftah, B. . (2021). Performance Evaluation of the Pallor in the Diagnosis of Anemia. International Journal of Next-Generation Computing, 12(5).


  1. WHO. Global nutrition targets 2025:policy brief series (WHO/NHM/NHD/14.2).Geneva : World Health Organization;2014
  2. WHO. Global nutrition targets 2025: Anemia policy brief (WHO/NHM/NHD/14.4).Geneva : World Health Organization;2014
  3. World Health Organization, Haemoglobin Colour Scale: Practical Answer to a vital Need, Department of Blood Safety and Clinical Technology, WHO, Geneva, Switzerland, 2001.
  4. H. Ranganathan and N. Gunasekaran, “Simple Method for Estimation of Hemoglobin in Human Blood Using Color Analysis,” IEEE Transactions on Information Technology In Biomedicine, Vol. 10, No. 4, October 2006 657
  5. J.Todd Kuenster, “Method for noninvasive (in-vivo) total hemoglobin, oxyhemoglobin, deoxy hemoglobin, carbooxy hemoglobin and methemoglobin concentration determination,” United State Patent , , US patent 5,692,503, issued, Dec. 2,1997
  6. G Zonios, J Bykowski, N Kollias “Skin Melanin, Hemoglobin, and Light Scattering Properties can be Quantitatively Assessed In Vivo Using Diffuse Reflectance Spectroscopy” - Journal of Investigative Dermatology, 2001, Elsevier
  7. N Sevani, Fredicia and G B V Persulessy, “Detection anemia based on conjunctiva pallor level using k-means algorithm”, IOP Conf. Ser.: Mater. Sci. Eng. 420 012101,2018
  8. Shaun Collings, Oliver Thompson,Evan Hirst,Louise Goossens,Anup George,Robert Weinkove ,”Non-Invasive Detection of Anaemia Using Digital Photographs of the conjunctiva”, PLoS ONE 11(4): e0153286 , /journal.pone .0153286,2016
  9. Natasha Ahmed, Khurshida Khan, Padmanabh Reddy, Uma Raju, “Reliability and Validity of Palmar, Mucosal, Nail Bed and Conjunctival Pallor for Anemia Detection in School Children Aged 6-14 Years of Age”, Int Arch BioMed Clin Res. 2020;7(1):PD1–PD5.
  10. Gregory D. Jay, Norfolk; C ager Selim Suner; Kevin S. Ernsting, “Non-Invasive Determination of Blood Components,” United State Patent Application Publication, US 7,711,403 B2, May 4, 2010
  11. C.C.Fan, Application of artificial classification techniques to assess the anemia conditions via palpebral conjunctiva color component(Master thesis), National Ilan University,Taiwan,2013
  12. Yi-Ming Chen , Shaou-Gang Miaou , Hongyu Bian , “Examining palpebral conjunctiva for anemia assessment with image processing methods,” Journal of Computer Methods And Programs In Biomedicine -125–135, Elsevier,2016
  13. H. A. Song and S.-Y. Lee, “Hierarchical representation using NMF,” in Proceedings of the International Conference on Neural Information Processing, 2013, pp. 466–473
  14. Goodfellow, J. Pouget-Abadie, M. Mirza, B. Xu, D. Warde-Farley, S. Ozair, A. Courville, and Y.Bengio, “Generative adversarial nets,” in Proceedings of the Advances in Neural Information ProcessingSystems, 2014, pp. 2672–2680
  15. Anemia detection in low resource settings: A manual for health workers[online]Avalilable:
  16. Yi-Ming Chen , Shaou-Gang Miaou , Hongyu Bian , “Examining palpebral conjunctiva for anemia assessment with image processing methods,” Journal of Computer Methods And Programs In Biomedicine -125–135, Elsevier,2016
  17. Manisha Das,Aleefia.A. Khurshid,”Image Processing to Quantitate Hemoglobin Level for Diagnostic Support”, Volume No 10 ,Issue No 01,February 2020
  18. Vitoantonio Bevilacqua, Giovanni Dimauro, Francescomaria Marino,Antonio Brunetti,Fabio Cassano, Antonio Di Maio, Enrico Nasca, Gianpaolo Francesco Trotta, FrancescoGirardi, Angelo Ostuni and Attilio Guarini, “ A novel approach to evaluate blood parameters using computer vision techniques,” IEEE Symposium on Medical Measurements And Applications May,2016.