Challenges in detection of adolescent anaemia: validation of point-of-care device (Mission® plus) for haemoglobin measurement among tribal residential school children of selected districts of Odisha, India

Abstract

Background: Screening for anemia among tribal school children has been a challenge. Objectives: To validate a point-of-care (POC) device (mission® plus hemoglobinometer) to the gold standard method, spectrophotometry. Study Design: Cross-sectional study. Participants: The representative sample of 953 tribal adolescents from the residential schools of Odisha. Methods: Hemoglobin was measured simultaneously by the POC and gold standard method during January to July 2019. The validity of the POC device was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The area under the curve was calculated using receiver operating characteristic (ROC) analysis. Concordance of the POC device with the gold standard method was determined by the Bland–Altman plot. The intraclass correlation coefficient (ICC), precision (⍴), a bias correction factor (Cb), and the concordance correlation coefficient were also calculated. Deming regression analysis was performed, and a linear equation was established. Results: The mean age of the study participants was 13.07 (±1.48) years. The prevalence of anemia was 45.54% by the gold standard method. The sensitivity and specificity of the POC device were 94.9% and 56.1%, respectively. PPV and NPVs were 64.4% and 93.0%, respectively. The area under the ROC curve was found to be 0.856. The ICC was 0.887 (95% confidence interval: 0.872–0.901). Conclusions: Very good reliability/absolute agreement for hemoglobin measurements existed between the POC device and the gold standard method making it suitable as a screening device.

Keywords

• adolescent
• anemia
• erythrocyte indices
• point-of-care testing
• population
• validation