Parental Perception of Childhood Anaemia and Efficiency of Instrument Assisted Pallor Detection among Mothers in Southeast Nigeria: A Field Validation Study

Use of point-of-care haemoglobin tests to diagnose childhood anaemia in low- and middle-income countries: A systematic review

OBJECTIVES

Anaemia is a major cause of mortality and transfusion in children in low- and middle-income countries (LMICs); however, current diagnostics are slow, costly and frequently unavailable. Point-of-care haemoglobin tests (POC(Hb)Ts) could improve patient outcomes and use of resources by providing rapid and affordable results. We systematically reviewed the literature to investigate what, where and how POC(Hb)Ts are being used by health facilities in LMICs to diagnose childhood anaemia, and to explore challenges to their use.

METHODS

We searched a total of nine databases and trial registries up to 10 June 2022 using the concepts: anaemia, POC(Hb)T, LMIC and clinical setting. Adults ≥21 years and literature published >15 years ago were excluded. A single reviewer conducted screening, data extraction and quality assessment (of diagnostic studies) using QUADAS-2. Outcomes including POC(Hb)T used, location, setting, challenges and diagnostic accuracy were synthesised.

RESULTS

Of 626 records screened, 41 studies were included. Evidence is available on the use of 15 POC(Hb)Ts in hospitals (n = 28, 68%), health centres (n = 9, 22%) and clinics/units (n = 10, 24%) across 16 LMICs. HemoCue (HemoCue AB, Ängelholm, Sweden) was the most used test (n = 31, 76%). Key challenges reported were overestimation of haemoglobin concentration, clinically unacceptable limits of agreement, errors/difficulty in sampling, environmental factors, cost, inter-observer variability and supply of consumables. Five POC(Hb)Ts (33%) could not detect haemoglobin levels below 4.5 g/dL. Diagnostic accuracy varied, with sensitivity and specificity to detect anaemia ranging from 24.2% to 92.2% and 70% to 96.7%, respectively.

CONCLUSIONS

POC(Hb)Ts have been successfully utilised in health facilities in LMICs to diagnose childhood anaemia. However, limited evidence is available, and challenges exist that must be addressed before wider implementation. Further research is required to confirm accuracy, clinical benefits and cost-effectiveness.

Prevalence and Predictors of Anemia Among Children Aged 6-23 Months in Dodota District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

Background

Globally, anemia is a public health problem affecting children living in both developed and developing countries with bad consequences on children’s cognitive, social, and economic development.

Objective

To assess the prevalence and predictors of anemia among children aged 6–23 months residing at Dodota district, Southeast Ethiopia.

Methods

A community-based cross-sectional study was conducted from January–July 2019, at Dodota district, in Southeast Ethiopia. Multistage, random, and systematic sampling techniques were employed to recruit households and study participants. Trained community health extension workers were involved in the data collection. Data were entered into Epi_info 7.2.2 for clean-up and exported to SPSS 21 for analysis. Frequency and proportion were used to describe nominal and ordinal variables. Mean with SD were used to describe continuous variables. Pearson correlation coefficient was used to assess correlation between numeric variables. Regressional analysis was used to assess factors predicting the occurrence of anemia. P<0.05 with 95% CI was considered significant.

Results

A total of 917 children were included and the prevalence of anemia was found to be 407 (44.4%, 95% CI=41.1–47.4). When stratified to age category, the prevalence of anemia was highest among the age group of 6–12 months. Lack of ANC visits, lack of iron supplementation during pregnancy, untimely initiation of complementary feeding, and initiation of cow’s milk before 1 year of age were factors associated with anemia.

Conclusion

The prevalence of anemia was at the level of major public health problems. Antenatal and obstetric factors as well as child feeding practices were risk factors associated with anemia; and utilizing obstetric and childcare practices is highly recommended to mitigate this public health problem.