Abstract
The aim of this study is to evaluate the accuracy of capillary hemoglobin (Hb) measurements in detecting anemia among low-income toddlers (aged 12–35 months) and pregnant women. In analyses of data among toddlers from Kansas City (n = 402) and St. Louis, Missouri (n = 236), and pregnant women at <20 weeks gestation from Cleveland, Ohio (n = 397), we compared subjects’ anemia status based on capillary Hb concentrations in finger puncture samples as measured by the HemoCue system with their anemia status based on venous Hb concentrations as measured by the HemoCue and Coulter Counter. The sensitivity of capillary blood analyses in identifying cases of anemia was 32.8% (95% Confidence Intervals (CI): 21.0%–46.3%), among Kansas City toddlers, 59.7% (95% CI: 45.8%–72.4%) among St. Louis toddlers, and 66.7% (95% CI: 46.0%–83.5%) among pregnant women in Cleveland; the corresponding specificities were 97.7%, 86.6%, and 96.7%, respectively. The correlation between HemoCue and Coulter Counter measurements of venous Hb (0.9) was higher than that between HemoCue measurements of capillary and venous blood (0.8). The results show that Hb measurements of capillary blood with HemoCue were not optimal for determining the anemia status of toddlers and pregnant women.
Highlights
Pregnant women and toddlers in the United States are at risk for anemia (i.e., low hemoglobin (Hb) concentration) related to iron deficiency [1,2,3]
Capillary blood analyzed with HemoCue yielded higher Hb values than venous blood analyzed with Coulter Counter among toddlers in Kansas City (Figure 1, Panel A)
The mean paired differences between Hb values derived from capillary blood analyzed with HemoCue and Hb values derived from venous blood analyzed with Coulter Counter varied by study site
Summary
Pregnant women and toddlers in the United States are at risk for anemia (i.e., low hemoglobin (Hb) concentration) related to iron deficiency [1,2,3]. An accurate means of measuring Hb concentration is important for clinical diagnosis of anemia, research, and public health practice. The detection of anemia is the most common method used to screen individuals for iron deficiency [5]. Because of the feasibility and low cost of measuring. Hb measurements are often used to estimate the prevalence of iron deficiency anemia, as well as to indicate the iron status of a population and the success of interventions to increase iron levels [5,6].
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