Frontiers in Global Women's Health (Oct 2024)

Diagnostic accuracy of a non-invasive spot-check hemoglobin meter, Masimo Rad-67® pulse CO-Oximeter®, in detection of anemia in antenatal care settings in Kenya

  • Angela Koech,
  • Angela Koech,
  • Angela Koech,
  • Isaac Mwaniki,
  • Joseph Mutunga,
  • Moses Mukhanya,
  • Emily Mwadime,
  • Marvine Ochieng,
  • Grace Mwashigadi,
  • Hiten D. Mistry,
  • Rachel Craik,
  • Peter von Dadelszen,
  • Marleen Temmerman,
  • Marleen Temmerman,
  • Stanley Luchters,
  • Stanley Luchters,
  • Stanley Luchters,
  • Geoffrey Omuse,
  • The PRECISE Network,
  • Patricia Okiro,
  • Onesmus Wanje,
  • Consolata Juma,
  • Charlotte Ndana,
  • Douglas Nyankira,
  • Tindi Otieno,
  • Rose Chebet,
  • Winfred Muithi,
  • Washingtone Owino,
  • Quinter Okello,
  • Michael Ochieng,
  • Margaret Wachira,
  • Kelvin Mbote,
  • Mercy Osele,
  • John Kibwanga,
  • Happy Mdigo,
  • Claire Ngure,
  • Joy Wanja,
  • Claire Kiti,
  • Winnie Nzoka,
  • Grace Anyange,
  • Robin Okello,
  • David Mwadziwe,
  • Ruth Mambo,
  • Sarah Maitha,
  • Juma Gumbo,
  • Jamal Salim,
  • Mary Kalido,
  • Salim Mwakanyenze,
  • Anne Mutua,
  • Asha Tunje,
  • Noveline Khatievi,
  • Nathan Barreh,
  • Belinder Orero,
  • Mwanajuma Khamisi,
  • Eric Mataza,
  • Said Lele,
  • Olivia Kasuu,
  • Susan Sidi,
  • Hassan Kopa,
  • Faith Pola,
  • Umberto D’Alessandro,
  • Anna Roca,
  • Hawanatu Jah,
  • Andrew Prentice,
  • Melisa Martinez-Alvarez,
  • Brahima Diallo,
  • Abdul Sesay,
  • Sambou Suso,
  • Yahaya Idris,
  • Baboucarr Njie,
  • Fatima Touray,
  • Fatoumata Kongira,
  • Modou F.S. Ndure,
  • Gibril Gabbidon,
  • Lawrence Gibba,
  • Abdoulie Bah,
  • Yorro Bah,
  • Esperança Sevene,
  • Anifa Vala,
  • Sonia Maculuve,
  • Corssino Tchavana,
  • Helena Boene,
  • Lazaro Quimice,
  • Salesio Macuacua,
  • Carla Carrilho,
  • Laura A. Magee,
  • Marie-Laure Volvert,
  • Thomas Mendy,
  • Donna Russell,
  • Prestige Tatenda Makanga,
  • Liberty Makacha,
  • Reason Mlambo,
  • Lucilla Poston,
  • Rachel Tribe,
  • Sophie Moore,
  • Tatiana Salisbury,
  • Aris Papageorghiou,
  • Alison Noble,
  • Hannah Blencowe,
  • Veronique Filippi,
  • Joy Lawn,
  • Matt Silver,
  • Joseph Akuze,
  • Ursula Gazeley,
  • Judith Cartwright,
  • Guy Whitley,
  • Sanjeev Krishna,
  • Marianne Vidler,
  • Jing (Larry) Li,
  • Jeff Bone,
  • Mai-Lei (Maggie) Woo Kinshella,
  • Domena Tu,
  • Ash Sandhu,
  • Kelly Pickerill,
  • Carla Carillho,
  • Benjamin Barratt

DOI
https://doi.org/10.3389/fgwh.2024.1427261
Journal volume & issue
Vol. 5

Abstract

Read online

BackgroundPoint of care hemoglobin meters play key roles in increasing access to anemia screening in antenatal care especially in settings with limited access to laboratories. We aimed to determine the diagnostic accuracy of a non-invasive spot-check hemoglobin (SpHb) meter, Masimo Rad-67® Pulse CO-Oximeter®, in the diagnosis of anemia in pregnant women attending antenatal care clinics in Kilifi, Kenya.MethodsThis was a diagnostic accuracy study that retrospectively evaluated SpHb against a validated reference standard of laboratory assessed hemoglobin (Lab Hb) by a SYSMEX XN-330 automated hematology analyzer. The study was nested within a prospective pregnancy cohort study that recruited unselected pregnant women from antenatal care clinics in two public hospitals in Kilifi County, coastal Kenya. Records with both SpHb and Lab Hb were selected from pregnancy visits between May 2021 and December 2022. Linear regression and Bland-Altman analysis were performed to compare the two tests and diagnostic accuracy parameters obtained for the diagnosis of anemia.ResultsA total of 2,975 records (from 2,203 unique participants), with paired SpHb and Lab Hb were analyzed. Linear regression showed a significant but weak positive correlation, a proportional bias of 0.44 (95% CI 0.41–0.47) and a constant of 7.59 (95% CI 7.30–7.87, p < 0.001). The median bias was 1.70 g/dl, with limits of agreement of −0.80 to 4.20. SpHb tended to be higher than Lab Hb on the low hemoglobin range but lower than Lab Hb on the high hemoglobin range. The sensitivity of SpHb in detecting anemia was 18.66%. Prevalence, specificity, positive predictive value, and negative predictive values were 46.37%, 96.77%, 83.33%, and 57.92% respectively.ConclusionOverall, SpHb by Masimo Rad-67® Pulse CO-Oximeter® did not accurately identify pregnant women with anemia and many cases would be missed. We would not recommend its use in antenatal care settings.

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