Gwetu et al., Pediat Therapeut 2013, 4:1 DOI: 10.4172/2161-0665.1000187 Open Access Research Article Volume 4 • Issue 1 • 1000187 Pediat Therapeut ISSN: 2161-0665 Pediatrics, an open access journal Hemocue Validation for the Diagnosis of Anaemia in Children: A Semi- Systematic Review Gwetu TP*, Chhagan MK, Craib M and Kauchali S Department of Public health, University of KwaZulu-Natal, Durban, South Africa Abstract Background: Numerous methods are endorsed for Haemoglobin (Hb) estimation and anaemia assessment. The Hemocue is being introduced for routine use in clinics and hospitals in many developing nations. There are a number of illustrative cases that establish a clinical connection readily, but these have mainly been with adults. This study seeks tore view literature on the diagnostic accuracy of the Hemocue among children. Methodology: This is a semi-systematic review of studies analysing the Hemocue device’s diagnostic accuracy determining haemoglobin levels among children aged zero to ffteen years. Results: 18 studies were included. The main fnding of this investigation is that the Hemocue system is a good screening test, being sensitive and reliably projecting necessity of a full blood count. It is not likely that diagnosis of a clinically signifcant condition can be overlooked by this investigation. Thus it would seem to be a useful method to use for Hb screening in appropriate situations. The studies reviewed generally reported a difference between the means obtained by Hemocue Laboratory analyser, though these did not reach statistical signifcance. A trend for underestimation of Hb values was reported with most studies. The Hemocue had a sensitivity range of 75-91%, specifcity range of 88-100% and positive predictive values ranging from 75-80% for the detection of anaemia. The mean difference in Hb from paired samples ranged from 0.2- 0.35 g/dl (0.7%). Conclusion: The Hemocue is comparable to usual laboratory methods for determination of Hb level in children. It is well appropriate for use in care of healthy paediatric patients and children with hematologic disorders. A full blood count is recommended when anaemia is identifed or in suspected non-anaemic iron defciency. *Corresponding author: T P Gwetu, Department of Public health, Maternal and Child health unit, University of Kwazulu-Natal, P/Bag 7 Congella, Durban, 4013, South Africa, Tel: +2733 387 9562; E-mail: tgwetu@gmail.com Received June 17, 2013; Accepted December 02, 2013; Published December 04, 2013 Citation: Gwetu TP, Chhagan MK, Craib M, Kauchali S (2013) Hemocue Validation for the Diagnosis of Anaemia in Children: A Semi-Systematic Review. Pediat Therapeut 4: 187. doi:10.4172/2161-0665.1000187 Copyright: © 2013 Gwetu TP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Anaemia; Diagnosis; Screening; Hemoglobinometry; Accuracy; Precision Introduction Haemoglobin (Hb) concentration is the most consistent anaemia indicator [1]. Most reliable methodologies for testing Hb concentration require some equipment that may not be available in primary care sites. Te Hemocue measures Hb level in undiluted capillary or venous blood. It is easily transportable, needs very little blood for analysis, does not require blood sample storage or refrigeration, gives immediate digital results and can be battery operated. Te device seems appropriate for feld surveys, anaemia surveillance at sentry sites and to evaluate the impact of nutritional intervention programs. For example, until three years ago the South African Blood Transfusion Service used only the CuSO4 method for Hb measurement in potential blood donors. Now, all of their sites have changed to the Hemocue system. Te Hemocue is also being rolled out to clinics and hospitals of South Africa where it has found widespread acceptance and is being used for rapid Hb assessment of both adults and children. Tis study reviewed the validity of the Hemocue compared to laboratory reference methods in children. Methods Inclusion criteria for studies Two reviewers identifed studies, extracted data, assessed methodological quality and compared results of studies analysing the diagnostic accuracy of the Hemocue with comparisons made against a laboratory based Hb analyser. Samples were population or hospital based. We also included studies that assessed Hemocue test reliability. Tis study focuses on anaemia detection in children from neonates up to age ffeen years. Electronic databases such as PubMed, Medline and Science Direct were explored using keywords such as Hemocue, Hb tests, anaemia screening, reliability and validity. Dates ranged from the early seventies when the Hemocue was invented up to January 2013. A semi-systematic literature review was applied; using two thematically separated data collection forms. Articles were reviewed in stages and by categorization. Available abstracts in English were all read before deciding which relevant full text to retrieve. We scored studies according to pre-determined criteria such as the evidence for accuracy, precision and potential clinical usefulness (unpublished observations). Te decision on which studies to include in this research was made afer further considering available data from each study using a specifcally formatted inclusion form. Te pre-designed inclusion form contained data on study quality, design and characteristics such as location, laboratory reference method used to assess Hb concentration, health care setting, age restrictions, sample size and outcome. A systematic review or meta-analysis would subsequently examine in more detail the limits to and determinants of efcacy in the identifed studies and provide an exhaustive summary of literature relevant to the research question Results Description of Studies 35 studies were found which analysed Hemocue Hb testing in children. Only 18 studies met the research criteria and were included in this study. Tese studies used dissimilar Hemocue devices, statistical P e d i a t ri c s & T h e r a p e u t i c s ISSN: 2161-0665 Pediatrics & Therapeutics