Evaluation of the diagnostic accuracy of the Haemoglobin Colour Scale to detect anaemia in young children attending primary healthcare clinics in Zanzibar
- 1 February 2012
- journal article
- research article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 17 (4), 423-429
- https://doi.org/10.1111/j.1365-3156.2011.02944.x
Abstract
This study evaluates the diagnostic accuracy of Haemoglobin Colour Scale (HCS), compared with clinical diagnosis, to detect anaemia and severe anaemia in preschool-age children attending primary healthcare clinics in rural Zanzibar. In all participants, haemoglobin (Hb) concentration was independently estimated by clinical examination for palmar pallor, HCS and HemoCue™. HemoCue was considered the reference method. Data collection was integrated into the usual health services and performed by local healthcare workers (HCWs). Sensitivity, specificity, positive and negative predictive values were calculated for HCS and clinical examination for palmar pallor. The limits of agreement between HCS and HemoCue, and inter-observer variability for HCS, were also defined. A total of 799 children age 2-59 months were recruited to the study. The prevalence of anaemia (Hb0.1) or specificity (P>0.1) between HCS and palmar pallor to detect severe anaemia. Haemoglobin Colour Scale does not improve the capacity of HCWs to diagnose anaemia in this population. Accuracy is limited by considerable variability in the performances of test operators. However, optimizing the training protocol for those using the test may improve performance.This publication has 7 references indexed in Scilit:
- Impact of Artemisinin-Based Combination Therapy and Insecticide-Treated Nets on Malaria Burden in ZanzibarPLoS Medicine, 2007
- Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysisBMC Pediatrics, 2005
- Haemoglobin colour scale for anaemia diagnosis where there is no laboratory: a systematic reviewInternational Journal of Epidemiology, 2005
- Methods for assessing reliability and validity for a measurement tool: a case study and critique using the WHO haemoglobin colour scaleStatistics in Medicine, 2004
- CONSORT statement: extension to cluster randomised trialsBMJ, 2004
- Training health workers to assess anaemia with the WHO haemoglobin colour scaleTropical Medicine & International Health, 2000
- Epidemiology of iron deficiency anemia in Zanzibari schoolchildren: the importance of hookwormsThe American Journal of Clinical Nutrition, 1997