Validation of Point of Care Hemoglobin Estimation Among Pregnant Women Using Digital Hemoglobinometers (HemoCue 301 and HemoCue 201+) as Compared with Auto-Analyzer

Yadav, Kapil; Kant, Shashi; Ramaswamy, Gomathi; Ahamed, Farhad; Jacob, Olivia Marie; Vyas, Himani; Kaur, Ravneet; Malhotra, Sumit; Haldar, Partha

doi:10.1007/s12288-019-01196-5

Cited by 21 publications

(25 citation statements)

References 15 publications

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“…The HemoCue 301 analyzer has shown moderate agreement of Hgb level estimation when compared with the gold standard hematology autoanalyzer. 22 Of the 1,981 eligible mother-child dyads, 90 were excluded because the mother refused a Hgb measurement (Figure 1). Measurements were used as both a continuous and discrete variable categorized into severe anemia, moderate anemia, mild anemia, normal Hgb, and high Hgb.…”

Section: Methodsmentioning

confidence: 99%

U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh

Carpenter

Billah

Lyons

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Low birth weight (LBW) is associated with a higher risk of neonatal mortality and the development of adult-onset chronic disease. Understanding the ongoing contribution of maternal hemoglobin (Hgb) levels to the incidence of LBW in South Asia is crucial to achieve the World Health Assembly global nutrition target of a 30% reduction in LBW by 2025. We enrolled pregnant women from the rural Tangail District of Bangladesh in a Maternal Newborn Health Registry established under The Global Network for Women’s and Children’s Health Research. We measured the Hgb of pregnant women at enrollment and birth weights of all infants born after 20 weeks gestation. Using logistic regression to adjust for multiple potential confounders, we estimated the association between maternal Hgb and the risk of LBW. We obtained Hgb measurements and birth weights from 1,665 mother–child dyads between July 2019 and April 2020. Using trimester-specific cutoffs for anemia, 48.3% of the women were anemic and the mean (±SD) Hgb level was 10.6 (±1.24) g/dL. We identified a U-shaped relationship where the highest risk of LBW was seen at very low (< 7.0 g/dL, OR = 2.00, 95% CI = 0.43–7.01, P = 0.31) and high (> 13.0 g/dL, OR = 2.17, 95% CI = 1.01–4.38, P = 0.036) Hgb levels. The mechanisms underlying this U-shaped association may include decreased plasma expansion during pregnancy and/or iron dysregulation resulting in placental disease. Further research is needed to explain the observed U-shaped relationship, to guide iron supplementation in pregnancy and to minimize the risk of LBW outcomes.

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Section: Methodsmentioning

confidence: 99%

U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh

Carpenter

Billah

Lyons

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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“…Using point-of-care HemoCue 301 machines for capillary blood, the Hb level can be determined immediately and communicated to the tested individual or its caregivers on the spot. 31 (The bias of HemoCue 301 anaemia assessments compared with laboratory tests is with 0.25 g/dL well below the WHO recommended threshold for point-of-care machines.) According to the WHO and the Indian Council of Medical Research definitions, a pregnant woman is anaemic if her Hb concentration falls below 11.0 g/dL.…”

Section: Methodsmentioning

confidence: 99%

Pregnancy anaemia, child health and development: a cohort study in rural India

et al. 2021

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ObjectiveTo assess how pregnancy anaemia affects the offspring’s early childhood development, child haemoglobin (Hb) levels child growth and diseases incidence 2 years after birth in a low-income setting. Furthermore, we investigate the mediating role of childhood Hb levels with disease incidences and skills.DesignProspective cohort study.Setting and participantsThe study participants are 941-999 mother–child dyads from rural Madhepura in Bihar, India. In 2015, the women were recruited during pregnancy from registers in mother–child centres of 140 villages for the first wave of data collection. At the time of the second wave in 2017, the children were 22–32 months old.Primary and secondary outcome measuresThe recruited women were visited at home for a household survey and the measurement of the women’s and child’s Hb level, child weight and height. Data on the incidence of diarrhoea and respiratory diseases or fever were collected from interviews with the mothers. To test motor, cognitive, language and socioemotional skills of the children, we used an adapted version of the child development assessment FREDI.ResultsThe average Hb during pregnancy was 10.2 g/dL and 69% of the women had pregnancy anaemia. At the age of 22–32 months, a 1 g/dL increase in Hb during pregnancy was associated with a 0.17 g/dL (95% CI: 0.11 to 0.23) increase in Hb levels of the child. Children of moderately or severely anaemic women during pregnancy showed 0.57 g/dL (95% CI: −0.78 to −0.36) lower Hb than children of non-anaemic women. We find no association between the maternal Hb during pregnancy and early skills, stunting, wasting, underweight or disease incidence. While childhood anaemia does not correlate with childhood diseases, we find an association of a 1 g/dl increase in the child's Hb with 0.04 SDs higher test scores.ConclusionsWhile pregnancy anaemia is a risk factor for anaemia during childhood, we do not find evidence for an increased risk of infectious diseases or early childhood development delays.

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“…The present study reported high sensitivity for both digital hemoglobinometers (Device A – 81% and Device B 301 – 83%) as compared with the gold standard hematology analyzer. In contrast, studies have reported high sensitivity of 82.1%[ 15 ] and 89.4%[ 11 ] for Device A, but varied sensitivity for device B (23.1%,[ 13 ] 68.7%,[ 7 ] 72%,[ 14 ] and 90%[ 16 ]). However, similar to sensitivity, Device B (86%) had relatively higher sensitivity compared to Device A (79%) in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…[ 13 14 15 ] The reported specificity for Device A was 63.6%[ 11 ] and 77.9%[ 15 ] and Device B was 72.1%–100%. [ 6 13 14 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

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

Yadav¹,

Kant²,

Ramaswamy³

et al. 2020

Indian J Community Med

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Introduction: India has launched Anemia Mukt Bharat (AMB) strategy in 2018, to deal with the high burden of anemia in the country. Point-of-care testing (POCT) of anemia using digital hemoglobinometers and treatment is one of the primary interventions under AMB. This study aimed to determine the diagnostic validity of digital hemoglobinometers (TrueHb and HemoCue 301) for screening of anemia compared to hematology analyzer. Methodology: A hospital-based, cross-sectional study was conducted among pregnant women attending antenatal clinics of a selected primary health center and subdivisional hospital of Haryana, India, during January 2019. Hemoglobin (Hb) levels of the pregnant women were estimated in digital hemoglobinometers using capillary blood samples and hematology analyzer using venous blood samples. Bias, limits of agreement (LOA), and validity of digital hemoglobinometers were assessed against a hematology analyzer. Results: A total of 110 pregnant women were included. Bias (LOA) in Hb values estimated using digital hemoglobinometers was −0.09 g/dL (−1.97 to 1.80 ) for HemoCue301 and −0.04 g/dL (−1.69 to 1.60) for TrueHb compared to the hematology analyzer. HemoCue ® 301 (sensitivity: 86% and specificity: 83%) had relatively higher sensitivity and specificity compared to TrueHb (sensitivity: 78.9% and specificity: 81%). Conclusions: Digital hemoglobinometers have high sensitivity and specificity. Thus, these can be a potential POCTs for screening of anemia in peripheral health facilities. Further studies are required to establish the validity of the digital hemoglobinometers at community settings.

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Validation of Point of Care Hemoglobin Estimation Among Pregnant Women Using Digital Hemoglobinometers (HemoCue 301 and HemoCue 201+) as Compared with Auto-Analyzer

Cited by 21 publications

References 15 publications

U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh

U-Shaped Association between Maternal Hemoglobin and Low Birth Weight in Rural Bangladesh

Pregnancy anaemia, child health and development: a cohort study in rural India

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

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