Crystal D Karakochuk1, Amynah Janmohamed2, Kyly C Whitfield2, Susan I Barr2, Suzanne M Vercauteren3, Hou Kroeun4, Aminuzzaman Talukder4, Judy McLean2, Timothy J Green2. 1. Food, Nutrition and Health, University of British Columbia, 2205 East Mall, Vancouver, BC V6T 1Z4, Canada. Electronic address: c_karakochuk@hotmail.com. 2. Food, Nutrition and Health, University of British Columbia, 2205 East Mall, Vancouver, BC V6T 1Z4, Canada. 3. Children's & Women's Health Centre of British Columbia, Division of Hematopathology, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada. 4. Helen Keller International, Cambodia Country Office, P.O. Box 168, Phnom Penh, Cambodia.
Abstract
BACKGROUND: Genetic hemoglobin (Hb) E variants are common in Cambodia and result in an altered and unstable Hb molecule. We evaluated two methods to measure Hb concentration among individuals with and without Hb variants using a hemoglobinometer (HemoCue) and a hematology analyzer (Sysmex XT-1800i). METHODS: We determined the bias and concordance between the methods among 420 Cambodian women (18-45 y). RESULTS: Bias and concordance appeared similar between methods among women with no Hb disorders (n=195, bias=2.5, ρc=0.68), women with Hb E variants (n=133, bias=2.5, ρc=0.78), and women with other Hb variants (n=92, bias=2.7, ρc=0.73). The overall bias was 2.6g/l, resulting in a difference in anemia prevalence of 11.5% (41% using HemoCue and 29.5% using Sysmex, p<0.001). Based on visual interpretation of the concordance plots, the HemoCue device appears to underestimate Hb concentrations at lower Hb concentrations and to overestimate Hb concentrations at higher Hb concentrations (in comparison to the Sysmex analyzer). CONCLUSIONS: Bias and concordance were similar across groups, suggesting the two methods of Hb measurement were comparable. We caution field staff, researchers and policy makers in the interpretation of data and the impact that bias between methods can have on anemia prevalence rates.
BACKGROUND: Genetic hemoglobin (Hb) E variants are common in Cambodia and result in an altered and unstable Hb molecule. We evaluated two methods to measure Hb concentration among individuals with and without Hb variants using a hemoglobinometer (HemoCue) and a hematology analyzer (Sysmex XT-1800i). METHODS: We determined the bias and concordance between the methods among 420 Cambodian women (18-45 y). RESULTS: Bias and concordance appeared similar between methods among women with no Hb disorders (n=195, bias=2.5, ρc=0.68), women with Hb E variants (n=133, bias=2.5, ρc=0.78), and women with other Hb variants (n=92, bias=2.7, ρc=0.73). The overall bias was 2.6g/l, resulting in a difference in anemia prevalence of 11.5% (41% using HemoCue and 29.5% using Sysmex, p<0.001). Based on visual interpretation of the concordance plots, the HemoCue device appears to underestimate Hb concentrations at lower Hb concentrations and to overestimate Hb concentrations at higher Hb concentrations (in comparison to the Sysmex analyzer). CONCLUSIONS: Bias and concordance were similar across groups, suggesting the two methods of Hb measurement were comparable. We caution field staff, researchers and policy makers in the interpretation of data and the impact that bias between methods can have on anemia prevalence rates.
Authors: Lulu X Pei; Hou Kroeun; Suzanne M Vercauteren; Susan I Barr; Tim J Green; Arianne Y Albert; Crystal D Karakochuk Journal: J Nutr Date: 2021-08-07 Impact factor: 4.798
Authors: Nicole M Delimont; Sirichat Chanadang; Michael V Joseph; Briana E Rockler; Qingbin Guo; Gregory K Regier; Michael R Mulford; Rosemary Kayanda; Mwita Range; Zidiheri Mziray; Ambaksye Jonas; Joseph Mugyabuso; Wences Msuya; Nina K Lilja; Sandra B Procter; Edgar Chambers; Sajid Alavi; Brian L Lindshield Journal: Curr Dev Nutr Date: 2017-04-25
Authors: William E S Donkor; Joshua Mbai; Fatmata Sesay; Sundus Ibrahim Ali; Bradley A Woodruff; Shuaib Mohamoud Hussein; Kheyriya Mohamed Mohamud; Ahmed Muse; Warsame Said Mohamed; Abdullahi Muse Mohamoud; Farhan Mohamed Mohamud; Nicolai Petry; Melanie Galvin; Rita Wegmüller; Fabian Rohner; Yvonne Katambo; James P Wirth Journal: BMC Public Health Date: 2022-02-09 Impact factor: 3.295