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A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Robust point-of-care methods are required to estimate anemia at the population level. The accurate methods are lab-based and cannot be used at the point ...

ICMR-National Institute of Nutrition

Population-based surveys commonly use point-of-care (POC) methods with capillary blood samples for estimating Hb concentrations; these estimates need to be validated by comparison with reference methods using venous blood. In a cross-sectional study in 748 participants (17-86 years, 708 women, Hb: 5·1 to 18·2 g/dl) from Hyderabad, India, we validated Hb measured from a pooled capillary blood sample by a POC autoanalyser (Horiba ABX Micros 60OT, ) by comparison with venous blood Hb measured by two reference methods: POC autoanalyser () and cyanmethemoglobin method (). These comparisons also allowed estimation of blood sample-related and equipment-related differences in the Hb estimates. We also conducted a longitudinal study in 426 participants (17-21 years) to measure differences in the Hb response to iron folate (IFA) treatment by the capillary blood POC method compared with the reference methods. In the cross-sectional study, Bland-Altman analyses showed trivial differences between source of blood ( and ; mean difference, limits of agreement: 0·1, -0·8 to 1·0 g/dl) and between analytical methods ( and ; mean difference, limits of agreement: < 0·1, -1·8 to 1·8 g/dl). Cross-sectional anaemia prevalence estimated using  did not differ significantly from  or . In the longitudinal study, the Hb increment in response to IFA intervention was not different when using  (1·6 ± 1·7 g/dl) compared with  (1·7 ± 1·7 g/dl) and  (1·7 ± 1·7 g/dl). The pooled capillary blood-autoanalyzer method () offers a practical and accurate way forward for POC screening of anaemia.

Point-of-care Hb measurement in pooled capillary blood by a portable autoanalyser: comparison with venous blood Hb measured by reference methods in cross-sectional and longitudinal studies.

Anemia control has hitherto been through prophylaxis with weekly iron folic acid (IFA) in Indian women of reproductive age (WRA). Recently, a more precise approach has been proposed, that uses a 'screen and treat with IFA' approach for anemic WRA, combined with continued prophylactic IFA in non-anemic WRA. The efficacy of this approach was assessed in Indian WRA, along with changes in iron status biomarkers.

Efficacy of iron-folic acid treatment for reducing anemia prevalence and improving iron status in women of reproductive age: A one-year longitudinal study.

The persistent high prevalence of anaemia among Indian women of reproductive age (WRA) despite aggressive long-term iron supplementation could be related to over-diagnosis from an inappropriately high haemoglobin (Hb) diagnostic cut-off. To develop an appropriate cut-off for Indian WRA, we hypothesized that during iron-folic acid (IFA) supplementation to a mixed (anaemic/non-anaemic) WRA population, the positive slope of the Hb-plasma ferritin (PF) response in anaemic women would inflect into a plateau (zero-response) as a non-anaemic status is reached. The 2.5th percentile of the Hb distribution at this inflection point will be the diagnostic Hb cut-off for iron-responsive anaemia.

Teena Dasi

Clinical Division

ICMR-National Institute of Nutrition

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Teena Dasi

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Clinical Division

ICMR-National Institute of Nutrition

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level

Clinical Division