Digital hemoglobinometers as point-of-care testing devices for hemoglobin estimation: A validation study from India

Yadav, Kapil; Kant, Shashi; Ramaswamy, Gomathi; Ahamed, Farhad; Vohra, Kashish

doi:10.4103/ijcm.ijcm_558_19

Cited by 7 publications

(10 citation statements)

References 12 publications

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“…A subset of study participants from West Bengal enrolled in the CNNS were randomly included in the validation study, which compared venous and capillary hemoglobin. The detailed methodology of these studies is described elsewhere [ 10 , 11 , 12 , 13 ]. Pregnant women (2 studies conducted in 2018 and 2019—dataset A and B) [ 12 , 13 ], 6- to 59-month-old children (1 study conducted in 2019–2022—dataset C) [ 11 ], and 1- to 19-year-old age group (1 study conducted in 2016–2018—dataset D) [ 10 ] were the study participants included in these 4 studies.…”

Section: Methodsmentioning

confidence: 99%

“…The detailed methodology of these studies is described elsewhere [ 10 , 11 , 12 , 13 ]. Pregnant women (2 studies conducted in 2018 and 2019—dataset A and B) [ 12 , 13 ], 6- to 59-month-old children (1 study conducted in 2019–2022—dataset C) [ 11 ], and 1- to 19-year-old age group (1 study conducted in 2016–2018—dataset D) [ 10 ] were the study participants included in these 4 studies. Uniform exclusion criteria such as the known history of hemoglobinopathies, metabolic disorders, and chronic diseases affecting blood flow were adopted in all four studies.…”

Section: Methodsmentioning

confidence: 99%

“…Hemoglobin estimation with an automated hematology analyzer (AHA) using venous blood estimates the hemoglobin level accurately, but it requires a laboratory setting and has feasibility issues, especially for field-based assessments [ 7 ]. With advances in healthcare diagnostics, various point-of-care tests (POCT) such as the cyanmethemoglobin method, WHO hemoglobin color scale, red blood cell protoporphyrin method, Sahli’s hemoglobinometer, and digital hemoglobinometers are available for estimation of hemoglobin in field settings [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Though the POCTs mentioned above are easy and feasible to use, the analytical validity of these is relatively suboptimal compared to the gold standard AHAs for hemoglobin estimation [ 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…With advances in healthcare diagnostics, various point-of-care tests (POCT) such as the cyanmethemoglobin method, WHO hemoglobin color scale, red blood cell protoporphyrin method, Sahli’s hemoglobinometer, and digital hemoglobinometers are available for estimation of hemoglobin in field settings [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. Though the POCTs mentioned above are easy and feasible to use, the analytical validity of these is relatively suboptimal compared to the gold standard AHAs for hemoglobin estimation [ 8 , 9 , 10 , 11 , 12 , 13 ]. Additionally, the accuracy of POCTs largely depends on the technician’s competence, proper sample collection procedure, and external environmental factors.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, the accuracy of POCTs largely depends on the technician’s competence, proper sample collection procedure, and external environmental factors. Studies have reported diverse sensitivity (24% to 90%) and specificity (60–96%) of these POCT devices in the hemoglobin estimation compared to AHA [ 8 , 9 , 10 , 11 , 12 , 13 ]. In the last two decades, digital hemoglobinometers using capillary blood have been widely used as POCT for estimating hemoglobin, especially in large-scale surveys and primary healthcare settings [ 2 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Correction Equation for Hemoglobin Values Obtained Using Point of Care Tests—A Step towards Realistic Anemia Burden Estimates

et al. 2022

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Digital hemoglobinometers have been used as point-of-care tests (POCT) to estimate the burden of anemia in community-based studies and national-level surveys in India. As the accuracy of hemoglobin estimated in POCT varies, there is a need for adjustments to the POCT-hemoglobin to ensure they are closer to reality and are comparable. We used data (collected between 2016 and 2020) (N = 1145) from four studies from India: three among pregnant women and 6–59-month-old children from Haryana and the fourth from a national nutritional survey among 1–19-year-old children. We compared the same individuals’ POCT-hemoglobin (capillary blood) and automated hematology analyzers (AHA) hemoglobin (venous blood) and developed a predictive linear regression model to obtain the correction equation for POCT-hemoglobin. We analyzed paired data from 1145 participants. The correction equation for obtaining the true hemoglobin value = 3.35 + 0.71 × POCT-hemoglobin using capillary blood (adjusted R2—64.4% and mean squared error −0.841 g/dL). In comparison with the AHA-hemoglobin, the mean difference of POCT-hemoglobin was 0.2 g/dL, while with the predicted Hb obtained from the correction equation it was 0.01 g/dL. The correction equation was the first attempt at deriving the true hemoglobin values from the POCTs. There is a need for multi-country collaborative studies to improve the correction equation by adjusting for factors affecting hemoglobin estimation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correction Equation for Hemoglobin Values Obtained Using Point of Care Tests—A Step towards Realistic Anemia Burden Estimates

et al. 2022

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Use of point‐of‐care haemoglobin tests to diagnose childhood anaemia in low‐ and middle‐income countries: A systematic review

Brehm,

South,

George

2023

Tropical Med Int Health

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ObjectivesAnaemia is a major cause of mortality and transfusion in children in low‐ and middle‐income countries (LMICs); however, current diagnostics are slow, costly and frequently unavailable. Point‐of‐care haemoglobin tests (POC(Hb)Ts) could improve patient outcomes and use of resources by providing rapid and affordable results. We systematically reviewed the literature to investigate what, where and how POC(Hb)Ts are being used by health facilities in LMICs to diagnose childhood anaemia, and to explore challenges to their use.MethodsWe searched a total of nine databases and trial registries up to 10 June 2022 using the concepts: anaemia, POC(Hb)T, LMIC and clinical setting. Adults ≥21 years and literature published >15 years ago were excluded. A single reviewer conducted screening, data extraction and quality assessment (of diagnostic studies) using QUADAS‐2. Outcomes including POC(Hb)T used, location, setting, challenges and diagnostic accuracy were synthesised.ResultsOf 626 records screened, 41 studies were included. Evidence is available on the use of 15 POC(Hb)Ts in hospitals (n = 28, 68%), health centres (n = 9, 22%) and clinics/units (n = 10, 24%) across 16 LMICs. HemoCue (HemoCue AB, Ängelholm, Sweden) was the most used test (n = 31, 76%). Key challenges reported were overestimation of haemoglobin concentration, clinically unacceptable limits of agreement, errors/difficulty in sampling, environmental factors, cost, inter‐observer variability and supply of consumables. Five POC(Hb)Ts (33%) could not detect haemoglobin levels below 4.5 g/dL. Diagnostic accuracy varied, with sensitivity and specificity to detect anaemia ranging from 24.2% to 92.2% and 70% to 96.7%, respectively.ConclusionsPOC(Hb)Ts have been successfully utilised in health facilities in LMICs to diagnose childhood anaemia. However, limited evidence is available, and challenges exist that must be addressed before wider implementation. Further research is required to confirm accuracy, clinical benefits and cost‐effectiveness.

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Anemia and associated factors among internally displaced children at Debark refugee camp, North Gondar, Northwest Ethiopia

Teketelew,

Bayleyegn,

Berta

et al. 2023

PLoS ONE

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Background Children in refugee camps, due to their living conditions, are the most vulnerable groups to suffer from anemia. Nutritional deficiencies, especially iron deficiency is the most common causes of anemia. However, there is limited information on the prevalence and associated factors of anemia in Ethiopia. Hence, this study aimed to assess the prevalence and associated factors of anemia among internally displaced children at Debark refugee camp, Northwest Ethiopia. Methods A cross-sectional study was conducted on 354 internally displaced children, at Debark refugee camp from March to May 2022. A systematic sampling technique was employed. The socio demographic characteristics were collected by using structured questionnaire via face-to-face interview with the caregivers. The hemoglobin level was determined using HemoCue301+. Form anemic children, venous blood sample was collected for iron profile analysis. Parasitological and anthropometric measurements were also done. The data were entered using Epi-data version 4.6.0.6 and exported to STATA version 14 for analysis. Bi-variable and multivariable binary logistic regression analysis were done. Both crude odds ratio and adjusted odds ratio with the corresponding 95% confidence interval were calculated to measure the strength of association. P-Value < 0.05 was considered as statistically significant association. Results From the total of 354 children included in this study, more than half (54.8%) of them were male. The median age of children was 7 years with interquartile range of (4–10) years. The total prevalence of anemia in this study was 33.62% (95% CI:28.7, 38.7). Moderate type anemia was predominant in this study. From anemic children 30 (25.2%) had iron deficiency anemia. In this study, low dietary diversity (AOR = 4.9; 95% CI: 2.0, 11.7), duration in the camp more than six months (AOR = 4.2; 95% CI:1.9, 9.4), presence of diarrhea (AOR = 2.7; 95% CI:1.3, 5.7), fever (AOR = 3.4; 95% CI:1.6, 7.1), and wasting (AOR = 3.6; 95% CI:1.3, 10.3) were significantly associated with the prevalence of anemia. Conclusion Anemia was moderate public health problem in the current study. Focused policies and strategies towards to internally displaced children should be designed to reduce anemia, by preventing the significant risk factors associated with anemia.

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Digital hemoglobinometers as point-of-care testing devices for hemoglobin estimation: A validation study from India

Cited by 7 publications

References 12 publications

Correction Equation for Hemoglobin Values Obtained Using Point of Care Tests—A Step towards Realistic Anemia Burden Estimates

Correction Equation for Hemoglobin Values Obtained Using Point of Care Tests—A Step towards Realistic Anemia Burden Estimates

Use of point‐of‐care haemoglobin tests to diagnose childhood anaemia in low‐ and middle‐income countries: A systematic review

Anemia and associated factors among internally displaced children at Debark refugee camp, North Gondar, Northwest Ethiopia

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