Correspondence of Hemoglobin Values Obtained by a Noninvasive, Cutaneous-Contact Method with Values Obtained by Conventional Methods from Whole Blood Samples in a Guatemalan Field Setting

Abstract

Background. Anemia is a widespread public health issue, conventionally diagnosed by analyzing the hemoglobin concentration in whole blood samples. Aspects of safety, comfort, and cultural acceptability would be obviated if reliable, noninvasive anemia screening were available.Objective. To determine day-to-day variations within subjects in hemoglobin measurements and the correspondence of hemoglobin values obtained by a noninvasive, photometric, cutaneous-contact method with values obtained by conventional methods from blood samples. Methods. The hemoglobin level was determined in 40 pregnant women from the Guatemalan coastal plain (low values) and 40 men from the highlands (high values).Hemoglobin concentrations (g/dl) were measured in an automated cell counter and, in parallel, estimated with the use of the Rad-87™ Rainbow pulse CO-Oximeter placed over the nail bed of the ring finger.Results. The mean value for invasively determined hemoglobin was 13.5 g/dl, as compared with 12.2 and 12.1 g/dl for the noninvasive nail-bed estimate at 10 and 5 minutes, respectively. Measurements using the noninvasive technology were highly stable within days and from day to day. The noninvasive screening method showed satisfactory sensitivity and specificity at hemoglobin concentrations of < 12.0 g/dl (cutoff value for nonpregnant women) and < 13.0 g/dl (cutoff value for adult men). Diagnostic discrimination was poorer for the lower cutoff criteria; the anemia cutoff values were < 11.5 g/dl for school-age children and < 11.0 g/dl for pregnant women and children under 5 years of age.Conclusions. Noninvasive hemoglobin screening shows considerable promise, although improvement of sensitivity and specificity in the anemic range and determination periods of less than 10 minutes are desirable.

Targeted Provision of Oral Iron: The Evolution of a Practical Screening Option

“…The Masimo Rad-87 TM has been evaluated twice, once alone (23) and again in a comparative study with the first generation of the Haemospect® (MBR Optical Systems GmbH) (24). In the former study, it proved to be highly stable within the day and over 14 d, but diagnostic discrimination was poor, especially in the lower concentration range that signifies anemia.…”

Efficacy and Safety of Iron Administration in Juvenile Populations

“…To avoid negative side effects, such as severe courses of Falciparum malaria and growth retardation, iron supplementation should, therefore, be targeted only to iron-deficient children. Because of the risk of spreading blood-borne diseases and the considerable effort and cost of full characterization of individual iron status in blood samples, noninvasive methods (inoffensive, laser-based skin probes) to determine hemoglobin concentrations are presently being tested [88] . Their response to iron supplementation can help to assess IDA noninvasively in children 1 6 months of age, which may offer a way out of the iron supplementation dilemma in malarial zones.…”

Eficacia y seguridad de la administración de hierro en poblaciones juveniles

“…Para evitar efectos secundarios negativos, como los cursos graves de paludismo por Falciparum y el retraso en el crecimiento, el aporte complementario de hierro debe dirigirse, en consecuencia, únicamente a niños con carencia de hierro. Debido al riesgo de diseminar enfermedades transmitidas por la sangre y al esfuerzo y coste considerables de la caracterización completa del estado de hierro individual en muestras sanguí-neas, se están investigando actualmente métodos no invasivos (inofensivos, sondas cutáneas basadas en láser) para determinar las concentraciones de hemoglobina [88] . Su respuesta al aporte complementario de hierro puede contribuir a evaluar la ACH de forma no invasiva en niños mayores de 6 meses, lo que puede ofrecer una vía ajena al dilema del aporte complementario de hierro en zonas palúdicas.…”