A Method Comparison Study between Two Hemoglobinometer Models (Hemocue Hb 301 and Hb 201+) to Measure Hemoglobin Concentrations And Estimate Anemia Prevalence among Women in Preah Vihear, Cambodia

Abstract

BackgroundAnemia affects 1.62 billion people worldwide. Defined as a hemoglobin (Hb) concentration <120 g/L for non‐pregnant women, anemia can negatively impact pregnancy outcomes and reduce work capacity. Hb is often measured in global health and nutrition surveys using a portable hemoglobinomter such as the Hemocue Hb 201+ (Hemocue, Angelholm, Sweden). More recently, a newer model was released (Hemocue Hb 301) utilizing slightly different methods to measure Hb as compared to the older model.ObjectiveTo measure bias and concordance between Hb concentrations using the Hemocue Hb 301 and Hb 201+ models in a rural field setting.MethodsHb concentration was measured in 175 rural Cambodian women (18–49 y) from Preah Vihear province using three Hemocue Hb 301 and three Hemocue Hb 201+ machines and using the same finger prick of blood in alternating order. Half of the samples (n=94) were measured using the Hb 301 model first, and the remaining samples (n=81) with the Hb 201+ first. Bias (the difference in means) and concordance were determined.ResultsOverall, mean ± SD Hb concentration was 116 ± 13 g/L using the Hb 201+ and 118 ± 12 g/L using the Hb 301. Anemia prevalence (Hb <120 g/L) for the Hb 201+ and Hb 301 was 58.3% (n=102) and 57.7% (n=101), respectively. Bias ± SD between methods was 2.0 ± 10.5 g/L and concordance (95% CI) was 0.63 (0.54, 0.72).ConclusionsBias was low and concordance was high between the two models, suggesting that the new Hemocue Hb 301 measures anemia prevalence comparably to the previous Hemocue Hb 201+ model. Further, anemia prevalence was very similar among the two models (57.7 vs. 58.3). The comparability of Hb measurements among different Hemocue models has important implications for the accurate estimations of anemia prevalence across time and among different surveys.Support or Funding InformationThe funding for this study was provided by the Danish Red Cross (Copenhagen, Denmark) and the University of Guelph (Guelph, Canada).