Wilkinson D, Sach M E
Centre for Epidemiological Research in Southern Africa, Medical Research Council, Hlabisa, KwaZulu-Natal.
S Afr Med J. 1997 Apr;87(4):463-5.
To determine the feasibility, accuracy and cost of developing a system of on-site screening for anaemia in pregnancy in primary care clinics.
Mobile clinic team in Hlabisa health district, KwaZulu-Natal.
Four hundred and forty-nine consecutive women attending antenatal clinics were screened for anaemia (haemoglobin < 10 g/dl) using copper sulphate solution; the results were compared with true haemoglobin levels as determined by an automated analyser. Three hundred women had haemoglobin concentration estimated with a portable haemoglobinometer and results compared with those from the automated analyser.
Screening with copper sulphate solution was highly sensitive (95.7%) but had low positive predictive value for anaemia (37.2%). Haemoglobin concentration estimated by haemoglobinometer correlated highly with results from the analyser (r = 0.82; P < 0.0001), and the mean difference in concentrations between the two methods was 1.1 g/dl. The average cost of screening all women with copper sulphate solution (6 cents/sample) and determining the true concentration in those screened as possibly anaemia (R2.64/sample) was 72 cents per woman. The cost of using an automated analyser was R6.20 per sample.
Combined use of copper sulphate solution and a haemoglobinometer is a feasible, accurate and cost-effective way of screening for and diagnosing anaemia in pregnant women, on-site, in primary care clinics.
确定在基层医疗诊所开发孕期贫血现场筛查系统的可行性、准确性和成本。
夸祖鲁 - 纳塔尔省赫拉比萨健康区的流动诊所团队。
使用硫酸铜溶液对连续449名参加产前诊所的妇女进行贫血筛查（血红蛋白<10 g/dl）；将结果与自动分析仪测定的真实血红蛋白水平进行比较。使用便携式血红蛋白仪对300名妇女的血红蛋白浓度进行估计，并将结果与自动分析仪的结果进行比较。
用硫酸铜溶液筛查具有高度敏感性（95.7%），但对贫血的阳性预测值较低（37.2%）。血红蛋白仪估计的血红蛋白浓度与分析仪的结果高度相关（r = 0.82；P < 0.0001），两种方法之间浓度的平均差异为1.1 g/dl。用硫酸铜溶液筛查所有妇女（6美分/样本）并确定那些被筛查为可能贫血者的真实浓度（2.64兰特/样本）的平均成本为每名妇女72美分。使用自动分析仪的成本为每个样本6.20兰特。
硫酸铜溶液和血红蛋白仪联合使用是在基层医疗诊所现场筛查和诊断孕妇贫血的一种可行、准确且具有成本效益的方法。
