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Original article
Comparison of haemoglobin assessments by HemoCue and two automated haematology analysers in young Laotian children
  1. Guy-Marino Hinnouho1,
  2. Maxwell A Barffour1,
  3. K Ryan Wessells1,
  4. Kenneth H Brown1,2,
  5. Sengchanh Kounnavong3,
  6. Bigphone Chanhthavong3,
  7. Kethmany Ratsavong3,
  8. Chidchamai Kewcharoenwong4,
  9. Sonja Y Hess1
  1. 1 Department of Nutrition, Program in International and Community Nutrition, University of California, Davis, California, USA
  2. 2 Nutrition and Global Development, Bill & Melinda Gates Foundation, Seattle, Washington, USA
  3. 3 National Institute of Public Health, Vientiane, Laos
  4. 4 Faculty of Associated Medical Sciences, Centre for Research and Development of Medical Diagnostic Laboratories, Khon Kaen University, Khon Kaen, Thailand
  1. Correspondence to Dr Guy-Marino Hinnouho, Program in International and Community Nutrition, Department of Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA; gmhinnouho{at}ucdavis.edu

Abstract

Background Haemoglobin (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.

Aim To compare Hb concentrations by Hemocue Hb301 and two automated haematology analysers in young children in rural communities of Lao PDR.

Methods Capillary 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.

Results Mean 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).

Conclusion Capillary 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.

  • paediatric haematology
  • diagnosis
  • epidemiology
  • evaluating instrument

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/jclinpath-2017-204786

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    Footnotes

    • Handling editor Mary Frances McMullin.

    • Contributors SYH was responsible of the design of the study. G-MH, MAB, KRW, SK, BC, KR and SYH supervised data collection. CK coordinated the complete blood count analyses with the Sysmex XT-1800i haematology analyser. G-MH completed the statistical analyses and drafted the manuscript. MAB, KRW, KHB and SYH edited the manuscript. All authors reviewed and approved the final manuscript.

    • Funding Funding for this research was provided by the Mathile Institute for the Advancement of Human Nutrition, Nutrition International (formerly known as the Micronutrient Initiative) and the Bill & Melinda Gates Foundation.

    • Competing interests KHB works for the Bill & Melinda Gates Foundation. The spouse of SYH works for the Bill & Melinda Gates Foundation. All other authors have no competing interests to declare.

    • Ethics approval National Ethics Committee for Health Research (Lao PDR), Institutional Review Board of the University of California, Davis (USA), and the Khon Kaen University Ethics Committee in Health Research (Thailand).

    • Provenance and peer review Not commissioned; externally peer reviewed.