Variation in haemoglobin measurement across different HemoCue devices and device operators in rural Cambodia

Rappaport, Aviva I; Barr, Susan I.; Green, Timothy; Karakochuk, Crystal D

doi:10.1136/jclinpath-2017-204351

Cited by 13 publications

(13 citation statements)

References 5 publications

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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%

“…However, emerging evidence indicates many methodological factors, including pre-analytic factors [15], can influence hemoglobin readings using the HemoCue®. Variance in the collection of capillary blood can lead to falsely low readings and in some cases higher readings [7,16,17]. Incorrect techniques include not allowing alcohol solution to dry before puncturing the finger, shallow puncture, squeezing or milking the finger, microcuvette contains air bubbles, incomplete filling and re-dipping of microcuvette, damaged or expired microcuvettes and blood clotting [17].…”

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confidence: 99%

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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%

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confidence: 99%

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

et al. 2020

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“…Similarly, inconsistent measurements were found using 12 different HemoCue Hb301 devices in a methodological study of women in Cambodia. 42 Further investigation is needed to determine inherent variability among different HemoCue Hb301 devices, and results should be routinely compared when multiples devices are deployed in a single study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of haemoglobin assessments by HemoCue and two automated haematology analysers in young Laotian children

et al. 2017

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BackgroundHaemoglobin (Hb) assessment by Hemocue is used widely for anaemia screening in both adults and children. However, few studies have compared the diagnostic accuracy of Hemocue with an automated haematology analyser in young children.AimTo compare Hb concentrations by Hemocue Hb301 and two automated haematology analysers in young children in rural communities of Lao PDR.MethodsCapillary blood was collected from 6-month-old to 23-month-old children (n=1487) for determination of Hb concentration by Hemocue Hb301. On the same day, venous blood was collected for complete blood count using one of two haematology analysers (XT-1800i, Sysmex, and BC-3000Plus, Mindray Medical International). In a subsample of children (n=129), venous Hb was also measured by HemoCue Hb301. Agreement between the two methods was estimated using Bland-Altman plots.ResultsMean capillary Hb by Hemocue was significantly higher than mean venous Hb by haematology analysers combined (108.4±10.3 g/L vs 102.3±13.1 g/L; P<0.001), resulting in a significantly lower anaemia prevalence (Hb <110 g/L) by Hemocue (53.7% vs 73.9%; P<0.001). The Bland-Altman assessment of agreement showed a bias of 6.1 g/L and limits of agreement were −11.5 g/L to 23.7 g/L. Mean venous Hb concentration by Hemocue Hb301 (113.6±14.0 g/L) was significantly higher than mean capillary Hb concentration by Hemocue Hb301 (110.0±10.7; P=0.03 g/L), which in turn was significantly higher than mean venous Hb concentration by the Mindray BC-3000Plus (102.3±17.4 g/L).ConclusionCapillary and venous Hb concentrations assessed by Hemocue Hb301 showed poor agreement compared with venous Hb by automated haematology analysers, resulting in significantly different anaemia prevalences.

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“…One major issue with the current HemoCue models is that real‐time calibration is not possible . If the device is not measuring the quality control within the recommended acceptable range, the manual recommends that the device should not be used and suggests the user contact technical assistance.…”

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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Variation in haemoglobin measurement across different HemoCue devices and device operators in rural Cambodia

Abstract: NCT02481375.

Cited by 13 publications

References 5 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

Comparison of haemoglobin assessments by HemoCue and two automated haematology analysers in young Laotian children

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

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