title: An accurate and inexpensive color-based assay for detecting severe anemia in a limited-resource setting.
abstract: Severe anemia is an important cause of morbidity and mortality among children in resource-poor settings, but laboratory diagnostics are often limited in these locations. To address this need, we developed a simple, inexpensive, and color-based point-of-care (POC) assay to detect severe anemia. The purpose of this study was to evaluate the accuracy of this novel POC assay to detect moderate and severe anemia in a limited-resource setting. The study was a cross-sectional study conducted on children with sickle cell anemia in Luanda, Angola. The hemoglobin concentrations obtained by the POC assay were compared to reference values measured by a calibrated automated hematology analyzer. A total of 86 samples were analyzed (mean hemoglobin concentration 6.6 g/dL). There was a strong correlation between the hemoglobin concentrations obtained by the POC assay and reference values obtained from an automated hematology analyzer (r=0.88, P<0.0001). The POC assay demonstrated excellent reproducibility (r=0.93, P<0.0001) and the reagents appeared to be durable in a tropical setting (r=0.93, P<0.0001). For the detection of severe anemia that may require blood transfusion (hemoglobin <5 g/dL), the POC assay had sensitivity of 88.9% and specificity of 98.7%. These data demonstrate that an inexpensive (<$0.25 USD) POC assay accurately estimates low hemoglobin concentrations and has the potential to become a transformational diagnostic tool for severe anemia in limited-resource settings.
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Patrick T
authors: PT
authors: McGann
authors: Emory University and Georgia Institute of Technology, Atlanta, Georgia.
authors: Erika A
authors: EA
authors: Tyburski
authors: Hospital Pediátrico David Bernardino, Luanda, Angola.
authors: Vysolela
authors: V
authors: de Oliveira
authors: Hospital Pediátrico David Bernardino, Luanda, Angola.
authors: Brigida
authors: B
authors: Santos
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Russell E
authors: RE
authors: Ware
authors: Emory University and Georgia Institute of Technology, Atlanta, Georgia.
authors: Wilbur A
authors: WA
authors: Lam
mesh_terms: D000740:Anemia; D001681:Biological Assay / Q000379:methods*; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003116:Color; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy
chemical_list: D006454:Hemoglobins