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Community and Public Health Nutrition (Poster Session)

(P20-033-24) Anemia Prevalence Estimates Among Women of Reproductive Age Were Lower Using HemoCue 301 Than When Using An Automated Hematology Analyzer in a High Anemia Setting in Ethiopia

Monday, July 1, 2024
12:45 PM – 1:45 PM CT
Location: Poster Board 527
Disclosure(s):
Desalegn Kuche Goa, MS: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: The reported prevalence of anemia has fluctuated in recent national surveys in Ethiopia, but Somali Regional State has consistently reported very high anemia in women of reproductive age (WRA). This study aimed to assess variation in anemia prevalence estimates using a hematology analyzer and the HemoCue 301.

Methods: This cross-sectional study was conducted in Kebribeyah Woreda (district) in the Somali Regional State. Participants were non-pregnant WRA (18-49 years old). All eligible women from randomly selected enumeration areas were invited to participate in the study. Trained laboratory professionals collected venous blood samples following standard procedures. Hemoglobin was measured immediately in the field using HemoCue 301 and transported to the nearest hospital for measurement in an automated hematology analyzer. Hemoglobin concentrations were adjusted for altitude based on household GPS readings. Data were analyzed using STATA 16.1 (StataCorp LLC, Texas, USA).

Results: Mean (± SD) hemoglobin concentration (n=852) for venous blood measured in the automated hematology analyzer was 9.9 ± 2.5 g/dL and was 11.2 ± 2.2 g/dL in the HemoCue 301. Anemia prevalence was significantly lower based on HemoCue 301 readings compared to the hematology analyzer. Altitude-adjusted anemia prevalence was 56.4% assessed by the HemoCue 301 and 82.4% with the hematology analyzer. The specificity of HemoCue 301 for anemia estimation was 86.6% and its sensitivity was 65.4% using the hematology instrument as the standard.

Conclusions: Using either method, anemia is a severe public health problem in the study area. HemoCue 301 underestimated anemia prevalence by 26.0 percentage points compared to the hematology analyzer in this high anemia setting. HemoCue 301 had lower sensitivity for anemia estimation compared to the hematology analyzer. Further study comparing both methods is recommended in a low anemia setting with a better-quality control system in place.

Funding Sources: This study was supported by the European Union and UNICEF Ethiopia.