Point-of-Care Testing for Anaemia in Children Using Portable Haematocrit Meter: A Pilot Study from Southwest Nigeria and Implications for Developing Countries

Abstract

BACKGROUND: Prompt and accurate diagnosis is needed to prevent the untoward effects of anaemia on children. Although haematology analyzers are the gold standard for accurate measurement of haemoglobin or haematocrit for anaemia diagnosis, they are often out of the reach of most health facilities in resource-poor settings thus creating a care gap. We conducted this study to examine the agreement between a point-of-care device and haematology analyzer in determining the haematocrit levels in children and to determine its usefulness in diagnosing anaemia in resource-poor settings. METHODS: EDTA blood samples collected from participants were processed to estimate their haematocrits using the two devices (Mindray BC-3600 haematology analyzer and Portable Mission Hb/Haemotocrit testing system). A pairwise t-test was used to compare the haematocrit (PCV) results from the automated haematology analyzer and the portable haematocrit meter. The agreement between the two sets of measurements was assessed using the Bland and Altman method where the mean, standard deviation and limit of agreement of paired results were calculated. RESULTS: The intraclass and concordance correlation coefficients were 0.966 and 0.936. Sensitivity and specificity were 97.85% and 94.51% respectively while the positive predictive and negative predictive values were 94.79% and 97.73%. The Bland and Altman`s limit of agreement was -5.5 ̶ 5.1 with the mean difference being -0.20 and a non-ignificant variability between the two measurements (p = 0.506). CONCLUSION: Haematocrit determined by the portable testing system is comparable to that determined by the haematology analyzer. We therefore recommend its use as a point-of-care device for determining haematocrit in resource-poor settings where haematology analyzers are not available.

Evaluation of point‐of‐care testing device for anemia detection: A cross‐sectional method comparison study from Thailand

“…Several methods are commonly used to assess an individuals’ hemoglobin (Hb) and hematocrit (Hct) levels, including automated hematology analyzers, microhematocrit centrifuge, gravimetric copper sulfate method, cyanmethemoglobin method, and color code Hb estimation. 4 , 5 , 6 , 7 Although automated hematology analyzers are the gold standard and produce significantly accurate results for diagnosing anemia, their availability is limited to the regional, provincial, and district hospital levels in Thailand. The microhematocrit centrifuge must be of good quality and should be well maintained to provide accurate results.…”

“…Moreover, it is not practical to transport the centrifuges to the remote areas of Thailand where an electrical power network supply may be inaccessible. The cyanmethemoglobin method is time‐consuming and labor‐intensive, 6 , 7 whereas both the gravimetric copper sulfate method and color code Hb estimation are subjective as estimator bias may be introduced. 4 , 5 , 7 Therefore, in resource‐poor settings, a handheld or portable point‐of‐care testing (POCT) device for Hb and Hct level assessment potentially plays a key role as a tool for anemia detection, improving the problems of delayed diagnosis and interventions that lead to increased morbidity and mortality.…”

“…The cyanmethemoglobin method is time‐consuming and labor‐intensive, 6 , 7 whereas both the gravimetric copper sulfate method and color code Hb estimation are subjective as estimator bias may be introduced. 4 , 5 , 7 Therefore, in resource‐poor settings, a handheld or portable point‐of‐care testing (POCT) device for Hb and Hct level assessment potentially plays a key role as a tool for anemia detection, improving the problems of delayed diagnosis and interventions that lead to increased morbidity and mortality. Additionally, it could be a powerful tool used in demographic and health surveys for a nationwide epidemiological study.…”

Quantitative absorption imaging of red blood cells to determine physical and mechanical properties

“…According to an estimation from the World Health Organization (WHO), 30% of the population in the world suffers from anemia, where developing and underdeveloped regions like Africa and South-East Asia are the most prevalent. The widespread nature of anemia has inspired researchers to develop point-of-care devices to analyze blood samples [26][27][28][29][30] for early detection. Recent advancements in the smartphone industry have seen devices containing high-resolution cameras with low light capability.…”

Uso de hemoglobinómetro como alternativa para la medición de hemoglobina y hematocrito en muestras de aves

“…Actualmente, existen muy pocos estudios que comparen la relación entre las metodologías clásicas y las mediciones por instrumentos ELA, teniendo en cuenta que aves, reptiles, anfibios y peces tienen glóbulos rojos nucleados. En este estudio, evaluamos y comparamos los valores de Hb y Hct en aves silvestres usando metodologías clásicas de la cianometahemoglobina y centrifugación, y por otra parte, haciendo uso del equipo ELA Mission® Hb (hemoglobinómetro portátil Mission Hb; ACON Labs Inc.-Mission Plus Hb Hemoglobin Testing System), el cual está diseñado para la medición de Hb y Hct en sangre humana (Ali, 2014;Oladele et al, 2016).…”