A method comparison study between two hemoglobinometer models (Hemocue Hb 301 and Hb 201+) to measure hemoglobin concentrations and estimate anemia prevalence among women in Preah Vihear, Cambodia

Rappaport, Aviva I; Karakochuk, Crystal D; Whitfield, Kyly C.; Kheang, Khin Meng; Green, Timothy

doi:10.1111/ijlh.12583

Cited by 22 publications

(21 citation statements)

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“…There may also be other as yet unmeasured factors that can lead to differences between surveys in anemia estimates. These may include the environmental factors that differentially affect accuracy of each method (e.g., humidity) [5], HemoCue® model [7,37,38], and biological variability [6,11]. Differences in survey sampling procedures may also have played a role [39].…”

Section: Discussionmentioning

confidence: 99%

Comparing hemoglobin distributions between population-based surveys matched by country and time

et al. 2020

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Background: Valid measurement of hemoglobin is important for tracking and targeting interventions. This study compares hemoglobin distributions between surveys matched by country and time from The Demographic and Health Survey (DHS) Program and the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Methods: Four pairs of nationally representative surveys measuring hemoglobin using HemoCue® with capillary (DHS) or venous (BRINDA) blood were matched by country and time. Data included 17,719 children (6-59 months) and 21,594 nonpregnant women (15-49 y). Across paired surveys, we compared distributional statistics and anemia prevalence. Results: Surveys from three of the four countries showed substantial differences in anemia estimates (9 to 31 percentage point differences) which were consistently lower in BRINDA compared to DHS (2 to 31 points for children, 1 to 16 points for women). Conclusion: We identify substantial differences in anemia estimates from surveys of similar populations. Further work is needed to identify the cause of these differences to improve the robustness of anemia estimates for comparing populations and tracking improvements over time.

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Section: Discussionmentioning

confidence: 99%

Comparing hemoglobin distributions between population-based surveys matched by country and time

et al. 2020

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“…More sensitive indicators could be needed to better characterize the associations between WASH and anemia. Finally, the variation in preanalytical factors ( 35 ), blood specimen type ( 36 ), drop of blood used ( 37 ), and measurement techniques ( 38 , 39 ) across surveys might affect Hb readings.…”

Section: Discussionmentioning

confidence: 99%

Association between anemia and household water source or sanitation in preschool children: the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

Addo

Williams

et al. 2020

The American Journal of Clinical Nutrition

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Background The associations between anemia and household water source and sanitation remain unclear. Objectives We aimed to assess the associations between anemia and household water source or sanitation in preschool children (PSC; age 6–59 mo) using population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Methods We analyzed national and subnational data from 21 surveys, representing 19 countries (n = 35,963). Observations with hemoglobin (Hb) and ≥1 variable reflecting household water source or sanitation were included. Anemia was defined as an altitude-adjusted Hb concentration <110 g/L. Household water source and sanitation variables were dichotomized as “improved” or “unimproved.” Poisson regressions with robust variance estimates were conducted for each survey, adjusting for child sex, age, household socioeconomic status, maternal education, and type of residence. Results Access to an improved water source and improved sanitation ranged from 29.9% (Burkina Faso) to 98.4% (Bangladesh, 2012), and from 0.2% (Kenya, 2007) to 97.4% (Philippines), respectively. Prevalence of anemia ranged from 20.1% (Nicaragua) to 83.5% (Bangladesh, 2010). Seven surveys showed negative associations between anemia and improved sanitation. Three surveys showed association between anemia and improved water, with mixed directions. Meta-analyses suggested a protective association between improved household sanitation and anemia [adjusted prevalence ratio (aPR) = 0.88; 95% CI: 0.79, 0.98], and no association between improved household water and anemia (aPR = 1.00; 95% CI: 0.91, 1.10). There was heterogeneity across surveys for sanitation (P < 0.01; I2 = 66.3%) and water (P < 0.01; I2 = 55.8%). Conclusions Although improved household sanitation was associated with reduced anemia prevalence in PSC in some surveys, this association was not consistent. Access to an improved water source in general had no association with anemia across surveys. Additional research could help clarify the heterogeneity between these conditions across countries to inform anemia reduction programs.

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“…This issue can be problematic if the device is being used in a time‐sensitive research project or survey. The reproducibility of results with the use of the HemoCue has also been frequently reported (these issues are discussed in further detail below).…”

Section: Anemia Assessmentmentioning

confidence: 97%

“…Significant differences in Hb concentration have also been observed between different HemoCue models: 201+ versus 301, and 201+ versus B‐Hemoglobin, as well as, among different HemoCue devices (of the same model) and device operators . Three studies suggest that the 301 gives higher Hb concentrations than the 201+ . This bias is of particular concern when different models are used at two different time points in a survey, or in comparing results from surveys using different models.…”

Section: Anemia Assessmentmentioning

confidence: 99%

Measurement and interpretation of hemoglobin concentration in clinical and field settings: a narrative review

Karakochuk

Hess

Moorthy

et al. 2019

Annals of the New York Academy of Sciences

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Anemia affects over 800 million women and children globally. Defined as a limited or insufficient functional red blood cell supply in peripheral blood, anemia causes a reduced oxygen supply to tissues and can have serious health consequences for women and children. Hemoglobin (Hb) concentration is most commonly measured for anemia diagnosis. Methods to measure Hb are usually invasive (requiring a blood sample); however, advances in diagnostic and clinical chemistry over the past decade have led to the development of new noninvasive methods. Accurate diagnosis at the individual level is important to identify individuals who require treatment. At the population level, anemia prevalence estimates are often the impetus for national nutrition policies or programs. Thus, it is essential that methods for Hb measurement are sensitive, specific, accurate, and reproducible. The objective of our narrative review is to describe the basic principles, advantages, limitations, and quality control issues related to methods of Hb measurement in clinical and field settings. We also discuss other biomarkers and tests that can help to determine the severity and underlying causes of anemia. In conclusion, there are many established and emerging methods to measure Hb concentration, each with their own advantages, limitations, and factors to consider before use.

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A method comparison study between two hemoglobinometer models (Hemocue Hb 301 and Hb 201+) to measure hemoglobin concentrations and estimate anemia prevalence among women in Preah Vihear, Cambodia

Abstract: The two models measured anemia prevalence comparably in this population of women in rural Cambodia.

Cited by 22 publications

References 10 publications

Comparing hemoglobin distributions between population-based surveys matched by country and time

Comparing hemoglobin distributions between population-based surveys matched by country and time

Association between anemia and household water source or sanitation in preschool children: the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

Measurement and interpretation of hemoglobin concentration in clinical and field settings: a narrative review

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