Skip to main content Accessibility help
×
Home

Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years

  • Alessandra da Silva Pereira (a1), Inês Rugani Ribeiro de Castro (a2), Flávia Fioruci Bezerra (a3), José Firmino Nogueira Neto (a4) and Ana Carolina Feldenheimer da Silva (a2)...

Abstract

Portable haemoglobinometers have been used in order to estimate the prevalence of anaemia in diverse settings. However, few studies have been conducted to evaluate their performance in children of different age groups in distinct epidemiological contexts. To evaluate the reproducibility and reliability of a portable haemoglobinometer for the diagnosis of anaemia in children <5 years Hb was measured in the venous blood of 351 children <5 years by an automated system (standard method) and in three capillary blood samples, using a portable haemoglobinometer (HemoCue®; test method). The reproducibility of the device and of the test method was evaluated using the intraclass correlation coefficient (ICC) (Hb in its continuous form), κ and prevalence-adjusted bias-adjusted κ (PABAK) (categorised variable: anaemia: yes/no). For test method validation, Bland–Altman analyses were performed and sensitivity, specificity, accuracy rate, positive predictive value (PPV) and negative predictive values (NPV) were calculated. The haemoglobinometer presented good device reproducibility (ICC = 0·79) and reasonable method reproducibility (puncture, collection and reading) (ICC = 0·71). Superficial and fair agreement (κ) and good agreement (PABAK) were observed among the diagnoses obtained through the test method. The prevalence of anaemia was 19·1 and 19·7 % using the standard and the test method, respectively, with no statistically significant differences. The test method presented higher specificity (87·7 %) and NPV (88·3 %) than sensitivity (50·7 %) and PPV (49·3 %), and intermediary accuracy rate (57·8 %). HemoCue® showed good device reproducibility and reasonable method reproducibility, as well as good performance in estimating the prevalence of anaemia. Nevertheless, it showed a fair reliability and low individual diagnostic accuracy.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

*Corresponding author: Alessandra da Silva Pereira, email aspnutri@gmail.com

References

Hide All
1.Lozof, B (2007) Iron deficiency and child development. Food Nutr Bull 28, S560S571.
2.Soliman, AT, Sanctis, V & Sanjay, K (2014) Anemia and growth. Indian J Endocrinol Metab 18, S1S5.
3.World Health Organization (2015) The Global Prevalence of Anaemia in 2011. Geneva: World Health Organization.
4.Rosenblit, J, Abreu, CR, Szterling, LN, et al. (1999) Evaluation of three methods for hemoglobin measurement in a blood donor setting. Rev Paul Med 117, 108112.
5.Vieira, RCS & Ferreira, HS (2010) Prevalência de anemia em crianças brasileiras, segundo diferentes cenários epidemiológicos (Prevalence of anaemia in Brazilian children according to different epidemiological scenarios). Rev Nutr Campinas 23, 433444.
6.Srivastava, T, Negandhi, H, Neogi, SB, et al. (2014) Methods for hemoglobin estimation: a review of ‘what works’. Hematol Transfus 2, 1028.
7.International Council for Standardisation in Haematology (ICSH) (1996) Recommendations for reference method for haemoglobinometry in human blood (ICSH standard 1995) and specifications for international haemiglobincyanide standard. Clin Pathol 49, 271274.
8.Azim, W, Parveen, S & Parveen, S (2002) Comparison of photometric cyanmethemoglobin and automated methods for hemoglobin estimation. J Ayub Med Coll Abbottabad 14, 2223.
9.Nkrumah, B, Nguah, SB, Sarpong, N, et al. (2011) Hemoglobin estimation by the HemoCue® portable hemoglobin photometer in a resource poor setting. BMC Clin Pathol 11, 5.
10.Chakravarthy, VK, Chandra, DN, Prasanna, BS, et al. (2012) Haemoglobin estimation by non-cyanide methods. J Clin Diagn Res 6, 955958.
11.Matta, IEA, Veiga, GV, Baião, MR, et al. (2005) Anemia em crianças menores de cinco anos que freqüentam creches públicas do município do Rio de Janeiro, Brasil (Anaemia in children under five who attend public day care centres in the city of Rio de Janeiro, Brazil). Rev Bras Saúde Matern Infant 5, 349357.
12.Guled, RA, Mamat, NB, Balachew, T, et al. (2017) Predictors and prevalence of anemia, among children aged 6 to 59 months in Shebelle zone, Somali region, eastern Ethiopia: a cross sectional study. Int J Dev Res 7, 11196.
13.Von Schenck, H, Falkenuon, M & Lundberg, B (1986) Evaluation of ‘HemoCue,’ a new device for determining hemoglobin. Clin Chem 32, 526529.
14.Cohen, AR & Seidl-Friedman, J (1988) Hemocue® system for hemoglobin measurement. Evaluation in anemic and nonanemic children. Am J Clin Pathol 90, 302305.
15.Morris, SS, Ruel, MT, Cohen, RJ, et al. (1999) Precision, accuracy, and reliability of hemoglobin assessment with use of capillary blood. Am J Clin Nutr 69, 12431248.
16.Sari, M, Pee, S, Martini, E, et al. (2001) Estimating the prevalence of anaemia: a comparison of three methods. Bull World Health Organ 79, 506511.
17.Neufeld, L, García-Guerra, A, Sánchez-Francia, D, et al. (2002) Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study. Salúd Pública Mex 44, 219227.
18.Bhaskaram, P, Balakrishna, N, Radhakrishna, KV, et al. (2003) Validation of hemoglobin estimation using Hemocue. Indian J Pediatr 70, 2528.
19.Cable, RG, Steele, WR, Melmed, RS, et al. (2012). The difference between fingerstick and venous hemoglobin and hematocrit varies by sex and iron stores. Transfusion 52, 10311040.
20.Shah, N, Osea, EA & Martinez, GJ (2014) Accuracy of noninvasive hemoglobin and invasive point-of-care hemoglobin testing compared with a laboratory analyzer. Int J Lab Hematol 36, 5661.
21.Patel, AJ, Wesley, R, Leitman, SF, et al. (2013) Capillary versus venous hemoglobin determination in the assessment of healthy blood donors. Vox Sang 104, 317323.
22.Gwetu, TP & Chhagan, MK (2015) Evaluation of the diagnostic accuracy of the HemoCue device for detecting anaemia in healthy school aged children in KwaZulu-Natal, South Africa. S Afr Med J 105, 596599.
23.Levy, TS, Méndez-Gómez-Humarán, I, Ruán, MCM, et al. (2017) Validation of Masimo Pronto 7 and HemoCue 201 for hemoglobin determination in children from 1 to 5 years of age. PLOS ONE 1 2, e0170990.
24.Boghani, S, Mei, Z, Perry, GS, et al. (2017). Accuracy of capillary hemoglobin measurements for the detection of Anemia among U.S. low-income toddlers and pregnant women. Nutrients 9, E253.
25.Hinnouho, GM, Barffour, M, Wessells, KR, et al. (2018) Comparison of haemoglobin assessments by HemoCue® and two automated haematology analysers in young Laotian children. J Clin Pathol 71, 532538.
26.Keszei, AP, Novak, M & Streiner, DL (2010) Introduction to health measurement scales. J Psychosom Res 68, 319323.
27.World Health Organization (2001) Archived: Iron Deficiency Anaemia: Assessment, Prevention and Control: a Guide for Programme Managers. Geneva: World Health Organization.
28.World Health Organization (2006) Child Growth Standards. Geneva: World Health Organization.
29.World Health Organization (2011) WHO Anthro Software, version 3.2.2. Geneva: World Health Organization. https://www.who.int/childgrowth/software/anthro_pc_manual_v322.pdf?ua=1 (accessed December 2019).
30.Streiner, DL, Norman, GR & Cairney, J (2015) Health Measurement Scales – a Practical Guide to Their Development and Use. Oxford, UK: Oxford University Press.
31.Byrt, T, Bishop, J & Carlin, JB (1993) Bias, prevalence, and κ. J Clin Epidemiol 46, 423429.
32.Byrt, T (1996) How good is that agreement? Epidemiology 7, 561.
33.Kawamura, T (2002) Interpretação de um teste sob a visão epidemiológica. Eficiência de um teste (Interpretation of a test from the epidemiological view. Efficiency of a test). Arq Bras Cardiol 79, 437441.
34.Radtke, H, Polat, G, Kalus, U, et al. (2005) Hemoglobin screening in prospective blood donors: comparison of different blood samples and different quantitative methods. Transfus Apher Sci 33, 3135.
35.Daves, M, Cemin, R, Zagler, EM, et al. (2016) Evaluation of capillary haemoglobin determination for anaemia screening in blood donation settings. Blood Transfus 14, 387390.
36.Mohan, G, Bhaskaran, R, Sudha, SP, et al. (2016) Comparison of pre donation hemoglobin screening methods – implications of quality and cost. Int J Contemp Med Res 3, 20642067.
37.Hagan, RD, Diaz, FJ & Horvath, SM (1978) Plasma volume changes with movement to supine and standing positions. J Appl Physiol 45, 414417.
38.Paiva, AA, Rondóa, PHC, Silva, SSB, et al. (2004) Comparison between the HemoCue® and an automated counter for measuring hemoglobin. Rev Saúde Pública 38, 585587.
39.Schottenfeld, J & Fraumeni, F (2006) Cancer Epidemiology and Prevention. Oxford, UK: Oxford University Press.
40.Shahshahani, HJ, Mera at, N & Mansouri, F (2013) Evaluation of the validity of a rapid method for measuring high and low haemoglobin levels in whole blood donors. Blood Transfus 11, 385390.
41.Malhi, SCRS, Pawar, MA, Kushwaha, MN, et al. (2016) Point of care hemoglobin testing in platelet pheresis donors: noninvasive versus invasive methods. Med J Armed Forces India 72, 338343.

Keywords

Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years

  • Alessandra da Silva Pereira (a1), Inês Rugani Ribeiro de Castro (a2), Flávia Fioruci Bezerra (a3), José Firmino Nogueira Neto (a4) and Ana Carolina Feldenheimer da Silva (a2)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.