Hackl Laura S, Karakochuk Crystal D, Mazariegos Dora Inés, Jeremiah Kidola, Obeid Omar, Ravi Nirmal, Ayana Desalegn A, Varela Veronica, Alayón Silvia, Dary Omar, Moorthy Denish
USAID Advancing Nutrition, John Snow Inc., Arlington, VA, USA.
Food, Nutrition and Health, The University of British Columbia, Vancouver, British Columbia, Canada.
J Nutr. 2024 Jul;154(7):2326-2334. doi: 10.1016/j.tjnut.2024.03.019. Epub 2024 Apr 3.
BACKGROUND: Anemia prevalence estimates reported in population surveys can vary based on the blood specimen source (capillary or venous) and analytic device (hematology autoanalyzers or portable hemoglobinometers) used for hemoglobin (Hb) determination. OBJECTIVES: This study aimed to compare accuracy and precision of Hb measurement in three blood specimen types on three models of hemoglobinometers against the results from venous blood from the same individuals measured on automated analyzers (AAs). METHODS: This multisite (Cambodia, Ethiopia, Guatemala, Lebanon, Nigeria, and Tanzania) study assessed Hb measurements in paired venous and capillary blood specimens from apparently healthy women (aged 15-49 y) and children (aged 12-59 mo) using three HemoCue® Hb models (201+, 301, and 801). Measurements were compared against reference values: venous blood in hematology AA and adjusted via regression calibration or mean difference in HemoCue® Hb. Venous, capillary pool, and single-drop capillary blood specimens were assessed for accuracy and precision. RESULTS: Venous blood measured using HemoCue® Hb 301 exhibited a positive mean error, whereas responses in HemoCue® Hb 201+ and 801 were nondirectional compared with the reference. Adjustment with the reference harmonized mean errors for all devices across study sites to <1.0 g/L using venous blood. Precision was highest for venous blood (±5-16 g/L) in all sites, lowest for single-drop capillary (±9-37 g/L), and intermediate (±9-28 g/L) for capillary pool blood specimen. Imprecision differed across sites, especially with both capillary blood specimens, suggesting different levels of personnel skills. CONCLUSIONS: Findings suggest that venous blood is needed for accurate and precise Hb determination. Single-drop capillary blood use should be discouraged owing to high measurement variability. Further research should evaluate the viability and reliability of capillary pool blood for this purpose. Accuracy of HemoCue® Hb devices can be improved via standardization against results from venous blood assessed using AA.
背景：人群调查中报告的贫血患病率估计值可能因用于血红蛋白（Hb）测定的血样来源（毛细血管血或静脉血）和分析设备（血液学自动分析仪或便携式血红蛋白仪）的不同而有所差异。 目的：本研究旨在比较三种血红蛋白仪对三种血样类型进行Hb测量的准确性和精密度，并与同一受试者静脉血在自动分析仪（AA）上的测量结果进行对比。 方法：这项多中心（柬埔寨、埃塞俄比亚、危地马拉、黎巴嫩、尼日利亚和坦桑尼亚）研究使用三种HemoCue®血红蛋白仪型号（201+、301和801），对明显健康的女性（15 - 49岁）和儿童（12 - 59个月）的配对静脉血和毛细血管血标本进行Hb测量。测量结果与参考值进行比较：血液学自动分析仪检测的静脉血，并通过回归校准或HemoCue®血红蛋白仪的平均差值进行调整。对静脉血、毛细血管混合血和单滴毛细血管血标本的准确性和精密度进行评估。 结果：使用HemoCue®血红蛋白仪301测量静脉血时显示出正的平均误差，而与参考值相比，HemoCue®血红蛋白仪201+和801的测量结果无方向性。使用静脉血对所有研究地点的所有设备进行参考校准后，平均误差均小于1.0 g/L。所有地点静脉血的精密度最高（±5 - 16 g/L），单滴毛细血管血最低（±9 - 37 g/L），毛细血管混合血标本的精密度居中（±9 - 28 g/L）。不同地点的不精密度有所差异，尤其是两种毛细血管血标本，这表明人员技能水平不同。 结论：研究结果表明，准确和精确的Hb测定需要使用静脉血。由于测量变异性高，应避免使用单滴毛细血管血。应进一步研究评估毛细血管混合血在此方面的可行性和可靠性。通过与使用自动分析仪评估的静脉血结果进行标准化，可以提高HemoCue®血红蛋白仪的准确性。
Rev Saude Publica. 2004-8
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