Agreement of point of care devices for anemia testing
1
Centre of Innovation for Public Health and Emergencies, Kamuzu University of Health Sciences, Lilongwe, Malawi
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
There is need for more screening devices to facilitate early diagnosis of anemia. The HemoCue device is the most used point of care device in Malawi for screening. The EzeCheck device is recent device that has shown great results is screening in several countries and commended for its portability and non invasiveness. This study will compare the agreement between the two devices to determine precision of the two.
METHODS:
A cross sectional design study was done Lilongwe in with adolescent women and women of reproductive age. Quantitative data was collected and anaemia testing was done using both devices. A bland altman analysis was used to compare the two.
RESULTS:
363 women were tested in which 6.8% of participants were classified as anemic using HemoCue cut-off values. The bland altman analysis demonstrated poor agreement between the two methods, with wide limits of agreement. The mean paired difference was –2.77 g/dL, indicating that EzeCheck systematically underestimated hemoglobin levels compared to HemoCue. Bias was more pronounced at lower hemoglobin values, where underestimation by EzeCheck was greatest.
CONCLUSIONS:
Operational challenges, including cold extremities, thick skin, and environmental factors, also affected performance. Addressing these limitations through improved device calibration, enhanced operator training, and adaptation to local conditions will be essential to enhance the tool’s utility.
There is need for more screening devices to facilitate early diagnosis of anemia. The HemoCue device is the most used point of care device in Malawi for screening. The EzeCheck device is recent device that has shown great results is screening in several countries and commended for its portability and non invasiveness. This study will compare the agreement between the two devices to determine precision of the two.
METHODS:
A cross sectional design study was done Lilongwe in with adolescent women and women of reproductive age. Quantitative data was collected and anaemia testing was done using both devices. A bland altman analysis was used to compare the two.
RESULTS:
363 women were tested in which 6.8% of participants were classified as anemic using HemoCue cut-off values. The bland altman analysis demonstrated poor agreement between the two methods, with wide limits of agreement. The mean paired difference was –2.77 g/dL, indicating that EzeCheck systematically underestimated hemoglobin levels compared to HemoCue. Bias was more pronounced at lower hemoglobin values, where underestimation by EzeCheck was greatest.
CONCLUSIONS:
Operational challenges, including cold extremities, thick skin, and environmental factors, also affected performance. Addressing these limitations through improved device calibration, enhanced operator training, and adaptation to local conditions will be essential to enhance the tool’s utility.
| eISSN: | 2654-1459 |
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