Hemocue Validation for the Diagnosis of Anaemia in Children: A Semi- Systematic Review

Abstract

Background: Numerous methods are endorsed for Haemoglobin (Hb) estimation and anaemia assessment. The Hemocue is being introduced for routine use in clinics and hospitals in many developing nations. There are a number of illustrative cases that establish a clinical connection readily, but these have mainly been with adults. This study seeks tore view literature on the diagnostic accuracy of the Hemocue among children. Methodology: This is a semi-systematic review of studies analysing the Hemocue device's diagnostic accuracy determining haemoglobin levels among children aged zero to fifteen years. Results: 18 studies were included. The main finding of this investigation is that the Hemocue system is a good screening test, being sensitive and reliably projecting necessity of a full blood count. It is not likely that diagnosis of a clinically significant condition can be overlooked by this investigation. Thus it would seem to be a useful method to use for Hb screening in appropriate situations. The studies reviewed generally reported a difference between the means obtained by Hemocue Laboratory analyser, though these did not reach statistical significance. A trend for underestimation of Hb values was reported with most studies. The Hemocue had a sensitivity range of 75-91%, specificity range of 88-100% and positive predictive values ranging from 75-80% for the detection of anaemia. The mean difference in Hb from paired samples ranged from 0.2-0.35 g/dl (0.7%). Conclusion: The Hemocue is comparable to usual laboratory methods for determination of Hb level in children. It is well appropriate for use in care of healthy paediatric patients and children with hematologic disorders. A full blood count is recommended when anaemia is identified or in suspected non-anaemic iron deficiency.

Evaluation of the diagnostic accuracy of the HemoCue device for detecting anaemia in healthy school- aged children in KwaZulu-Natal, South Africa

“…[12] We found a very high coefficient of variation (1.63) for the HemoCue, which was higher than that documented by other researchers investigating the performance of the device under fieldwork conditions. [11] The mean difference for Hb values was 0.47 g/dL and the 95% limits of agreement between the HemoCue and laboratory Hb values were -1.07 -2.02 g/dL, indicating that the two measurement methods agreed closely in estimating small values but disagreed with larger values (Fig. 2).…”

“…These values are near the top of the range reported in earlier studies, where sensitivity ranged from 75% to 91%, specificity from 88% to 100%, and PPVs from 75% to 86%. [11] Differences in anaemia detection and estimates of severity could influence statistical estimates in screening initiatives and surveys. When screening for anaemia, a high sensitivity as opposed to a high specificity is desirable, because poor outcomes are likely with untreated chronic anaemia.…”

“…Accordingly, data obtained from the field can be assumed to be of the same level of reliability as data obtained in laboratory settings. The diagnostic precision of the HemoCue in laboratory settings is widely acknowledged, [11] but its performance outside the laboratory setting has been questioned. Morris et al [13] suggested the use of repeat sampling to minimise the effect of unreliability.…”

How Effective Is Iron Supplementation During Pregnancy and Childhood in Reducing Anemia Among 6–59 Months Old Children in India?

“…For women's supplementation, we only took those women who had taken the supplements for at least 50 days out of the 100day criteria. The NFHS-4 survey used the HemoCue Hb 201+ instrument which has a sensitivity of 75-91% and specificity of 88-100% for anemia (62). This instrument is mainly used for screening of anemia and requires a full blood count for confirmation (62).…”

“…The NFHS-4 survey used the HemoCue Hb 201+ instrument which has a sensitivity of 75-91% and specificity of 88-100% for anemia (62). This instrument is mainly used for screening of anemia and requires a full blood count for confirmation (62). The test results do not differentiate types of anemia.…”