The use of a portable field device for diagnostic screening of anemia in children aged 6 to 36 months: is it worth it?

Anemia, predominantly caused by iron deficiency, is a prevalent condition in childhood that can impair physical and cognitive development. Alternative methods may facilitate rapid and accurate diagnosis. This study aims to evaluate the accuracy of a portable hemoglobinometer in diagnosing anemia and iron deficiency. A cross-sectional study was conducted with 96 children followed in ten primary healthcare units in the municipality of Lavras, Minas Gerais, Brazil, between January and December 2023. Data collection included socioeconomic and demographic information, laboratory tests of the children (serum concentrations of hemoglobin, C-reactive protein, and ferritin quantified using the Hemacounter SL), and hemoglobin measurement in capillary blood using the portable hemoglobinometer HemoCue – ß Hemoglobin Photometer (Hb 201+). The prevalence of anemia by Hemocounter SL was 5.2% (95% CI: 2.1–12.1). The HemoCue® device demonstrated a sensitivity (Se) of 100%, specificity (Sp) of 84%, positive predictive value (PPV) of 21.7%, negative predictive value (NPV) of 100%, and an overall accuracy of 81.2% compared to the Hemacounter SL (gold standard) for the diagnosis of anemia. For the diagnosis of iron deficiency, the HemoCue® showed a sensitivity of 45%, specificity of 82%, PPV of 39.1%, NPV of 85%, and an accuracy of 74%. The estimated accuracy values and diagnostic properties of the HemoCue®, along with its operational advantages, support its use as an important tool for anemia screening in the pediatric population during routine consultations, especially in regions with limited healthcare resources. However, the device should not be used for the diagnosis of iron deficiency.