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An accurate hemoglobin estimation method is lacking at the point of care and may hinder population-based programs for treating anemia. Therefore, we developed a point-of-care method based on pooled capillary blood and an auto-analyzer integrated into a custom software application to categorize the hemoglobin values into different grades of anemia.
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 of care. To address this caveat, a novel method based on pooled capillary blood and a portable autoanalyzer was developed for the estimation of Hb. Additionally, custom software was developed for near-real-time integration of the Hb values from the auto analyzer to the server. Moreover, a decision support tool that can immediately categorize the participants into different stages of anemia was developed. The decision support tool was designed based on the World Health Organization (WHO) cut-off for anemia at the population level and was available for all age and gender groups. This simple and user-friendly tool could easily be used by front-line health workers who have limited technical skills. Overall, the method developed could be used at the point of care and is accurate. This high-throughput method could be used for screening anemia at the population level for all age and gender groups.
Anemia is a major public health problem globally, particularly in India. It is well known that anemia has a detrimental impact on the work productivity of the population and the economic growth of the country1. To leverage the national-level efforts to reduce anemia, the latest public health program initiated in 2018 is the Anemia Mukt Bharat program (AMB). AMB identifies 'testing' followed by tailored 'treatment' as one of the most promising approaches to reducing anemia prevalence in vulnerable age groups2. However, accurate point of care (POC) estimation of hemoglobin (Hb) for diagnosing anemia is need....
The protocol follows the guidelines of the Institutional Review Board of the ICMR-National Institute of Nutrition, Hyderabad, India (IRB. No.08/I/2018).
1. Pooled capillary sample collection for Hb analysis using hematology analyzer10,11
Testing the validity of the method
The validity of this method was established by comparing it with the gold standard, which was the venous blood autoanalyzer-based method. The validation study has been described in detail elsewhere8. Briefly, 748 apparently healthy volunteers provided a venous sample and a capillary sample consecutively on the same day. The analyses were conducted at the POC. The participants had a wide range of Hb values and belonged to categories of no-an.......
The current paper describes a point-of-care method using a pooled capillary blood sample and an auto-analyzer. The method was integrated with custom software, which could upload the results from the analyzer automatically to the server and generate decisions on anemia. Also, it could provide the treatment doses of IFA as per the protocol of the National program2.
The custom software was designed to integrate barcode printing, hematology data export, and visualization of.......
The team acknowledges Mr. J Suresh, Mr. Medappa, Mrs. Madhu, and the entire Kavintech Corporation, Bangalore team, who successfully developed the decision support tool and the software. The authors wish to also acknowledge the Indian Council of Medical Research, Government of India for funding and the Department of public health and family welfare, Telangana for facilitating the study.
....Name | Company | Catalog Number | Comments |
ABX Miniclean | Horiba Ltd, Japan | 23-450-004 | Enzymatic solution |
ABX Minidil LMG | Horiba Ltd, Japan | 23-450-008 | Buffered isotonic solution for RBC/PLT dilution, sleeving and cleaning |
ABX Minilyse | Horiba Ltd, Japan | 23-450-006 | Hb measurement; lysing solution |
ABX Minocal | Horiba Ltd, Japan | 2032002 | Calibrator |
ABX Minoclair | Horiba Ltd, Japan | 23-450-003 | Cleaning reagent |
ABX Minotrol 16 - 2H | Horiba Ltd, Japan | 2042209 | Blood control |
ABX Minotrol 16 - 2L | Horiba Ltd, Japan | 2042208 | Blood control |
ABX Minotrol 16 - 2N | Horiba Ltd, Japan | 2042202 | Blood control |
Autoanalyzer | Horiba Ltd, Japan | ABX Micros ES 60 | The FTP port should be functional |
Barcode printer | Technology service corporation, USA | TSC Model TE 244 | 400 Mhz 32 bit RISC processor with 16 MB SDRAM, 8 MB Flash memory |
Barcode Scanner | Retsol | LS-450 | Any company which can provide a scanner with the following specifications: 32 bit CPU fast decode ability, IP 54 rated, Light source – visible laser diode 650 nm, Single scan pattern with scan rate of 100scans/second, Scan width of 200 mm & precision of 4 mil, Scan angle – YAW 65 Deg, Rotation 30 Deg & Pitch 55 Deg, Scan indication – buzzer, light indicator, Scan mode both manual & continue scanning |
BD needles holder | Becton, Dickinson and company Ltd, Dublin, Ireland | 364879 | |
Contact activated lancet | Becton, Dickinson and company Ltd, Dublin, Ireland | 366594, 366593 | For children below 1 year, venous blood sample has been collected. |
Custom software | Kavin Corporation, Bangalore | N/A | |
K2-EDTA Microtainer-5 mL | Becton, Dickinson and company Ltd, Dublin, Ireland | 363706 | EDTA tube for blood profile analysis with 1.0 mg K2 EDTA, dimensions 13 x 75 mm |
Labels | G-Technologies, Secunderabad, telangana | N/A | |
Laptop | Any | N/A | Intel Core I3-1005G1, 8GB DDR4, 1TB HDD, 15.6 FHD LED, WIN 11 HOME and MS OFFICE H&S |
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