Comparing HemoCue® and Quantitative Buffy Coat® and Coulter Counter-measured haemoglobin concentrations in African children with acute uncomplicated malaria: a Bland-Altman analysis

Background

Anemia is a serious problem caused by malaria, and diagnosing it correctly is essential for proper treatment. Traditional laboratory tests to measure hemoglobin (Hb) levels, such as the Coulter Counter and Quantitative Buffy Coat® (QBC®), can be expensive and are not always available in low-resource areas. The HemoCue® test is a more affordable option that works well in rural settings.

Study Purpose

This study aimed to compare the accuracy of the HemoCue® test with the more traditional methods (Coulter Counter and QBC®) for measuring Hb levels in children with malaria.

Methods

The research was part of a larger trial involving Ugandan and Congolese children with uncomplicated malaria. Hb levels were measured at several time points using all three methods. The goal was to see how closely the results matched, with acceptable differences set at ± 0.5 g/dL.

Results

The analysis revealed that the HemoCue® test generally reported lower Hb levels compared to the other methods. The differences were greater than the acceptable range, indicating that HemoCue® should be used carefully, especially when deciding on blood transfusions.

Conclusions

While HemoCue® is a useful tool, it tends to underestimate Hb levels, particularly at higher concentrations. Caution is advised when using it for critical decisions in healthcare settings.

Opportunities for Improvement

Based on the trial data, clinics can:

Define Measurable Outcomes: Set clear goals for using the HemoCue® test in diagnosing anemia in malaria patients.
Select AI Tools: Choose AI solutions that can assist in analyzing hemoglobin levels accurately.
Implement Step by Step: Start with a pilot project to track the effectiveness of the HemoCue® test and its impact on patient care.