Article Category:
Research Article

Evaluation of the Performance of Portable Hemoglobinometers at Measuring Hemoglobin and Detecting Anemia in a Periurban Pediatric Population in Lima, Peru

Zach Silverstein Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland;
Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;

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Alicia Alva Mantari Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;
Image Processing Research Laboratory, Universidad de Ciencias y Humanidades, Lima, Peru;

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Kimberly Breglio Department of Dermatology, Duke University Hospital, Durham, North Carolina;

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Monica J. Pajuelo Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;
Asociación Benéfica PRISMA, Lima, Peru;

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Gladys Valdiviezo Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Sandra Cruz Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Pamela Castañeda Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Jessica D. Rothstein Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland;
Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, Illinois

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Lucia Huaman-Fernandez Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Lilia Cabrera Asociación Benéfica PRISMA, Lima, Peru;

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Mario Salguedo Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Franklin Barrientos Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Bryan Saldivar-Espinoza Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Dennis Núñez-Fernández Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Robert H. Gilman Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland;

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Patricia Sheen Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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Avid Roman-Gonzalez Image Processing Research Laboratory, Universidad de Ciencias y Humanidades, Lima, Peru;

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Sassan Noazin Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland;

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Mirko Zimic Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e ingeniería, Universidad Peruana Cayetano Heredia;

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DOI:
https://doi.org/10.4269/ajtmh.24-0494
Volume/Issue:
Ahead of Print
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As many as one in three people worldwide have anemia, with young children at increased risk of both disease and complications. In settings without clinical laboratories, portable hemoglobinometers serve important roles in diagnosing anemia and estimating prevalence. Here, we assess the validity of two such point-of-care devices—the HemoCue Hb201 and the HemoCue Hb301—relative to the international reference standard, the cyanmethemoglobin method. In total, 428 children ages 6–60 months were recruited at health posts in Lima, Peru, and venous and capillary blood samples were collected from each participant. Venous blood was assessed with the cyanmethemoglobin method, whereas capillary blood was assessed using the Hb201 and the Hb301; 16.1% of participants were found to have anemia using the cyanmethemoglobin method. Both the Hb201 (43.7%) and the Hb301 (20.6%) overestimated this prevalence, with the former reaching statistical significance (P <0.0001 and P = 0.11, respectively). Both devices also tended to underestimate hemoglobin concentration, with the Hb201 (mean difference = −0.99 g/dL; percentage error = −8.1%) being appreciably less accurate than the Hb301 (mean difference = −0.35 g/dL; percentage error = −2.7%). Areas under the curve for the Hb201 (0.92) and the Hb301 (0.93) were statistically similar (P = 0.28); however, the Hb201 incorrectly classified 29.4% of participants compared with 11.0% for the Hb301. Both devices had more false positives than false negatives. In conclusion, the Hb301 was found to be significantly more accurate than the Hb201 at measuring hemoglobin, diagnosing anemia, and estimating anemia prevalence.

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Author Notes

Financial support: This study was funded by a grant from the Programa Nacional de Innovación para la Competitividad y Productividad del Ministerio de la Producción-Perú (556-INNOVATEPERU-ISDA-2017) awarded to M. Zimic.

Current contact information: Zach Silverstein, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, E-mail: zsilverstein91@gmail.com. Alicia Alva Mantari, Monica J. Pajuelo, Gladys Valdiviezo, Sandra Cruz, Pamela Castañeda, Lucia Huaman-Fernandez, Mario Salguedo, Franklin Barrientos, Bryan Saldivar-Espinoza, Patricia Sheen, and Mirko Zimic, Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: aalva@uch.edu.pe, monica.pajuelo.t@upch.pe, gladys.valdiviezo.v@upch.pe, sandra_cruz102@gmail.com, pamela.castaneda.d@upch.pe, lucia.huaman.f@upch.pe, mario.salguedo.b@uni.pe, franklin.barrientos.p@upch.pe, bryan.saldivar.e@upch.pe, patricia.sheen@upch.pe, and mirko.zimic@upch.pe. Kimberly Breglio, Department of Dermatology, Duke University Hospital, Durham, NC, E-mail: kimberly.breglio@duke.edu. Jessica D. Rothstein, Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, E-mail: jrothst@uic.edu. Lilia Cabrera, Asociación Benéfica PRISMA, Lima, Peru, E-mail: lzcabrera28@gmail.com. Dennis Núñez-Fernández, Department of Digital Sciences, Université Paris Cité, Paris, France, E-mail: dennishnf@gmail.com. Robert H. Gilman and Sassan Noazin, Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, E-mails: rgilman1@jhu.edu and snoazin1@jhu.edu. Avid Roman-Gonzalez, Image Processing Research Laboratory, Universidad de Ciencias y Humanidades, Lima, Peru, E-mail: avid.roman-gonzalez@ieee.org.

Address correspondence to Mirko Zimic, Molecular Biology, Bioinformatics Unit, Laboratorio de Bioinformática, Biología Molecular y Desarrollos Tecnológicos, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, SMP, Lima 41, Peru. E-mail: mirko.zimic@upch.pe
Copyright:
© American Society of Tropical Medicine and Hygiene 2024
Received:
21 Jul 2024
|
Accepted:
24 Jul 2024
|
Published Online:
10 Dec 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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