Performance of Hb HemoCue Machine Compared to Automated Hematology Analyzer for Hemoglobin Measurements Among Adult Patients at Kilimanjaro Christian Medical Centre

Abstract

Background: Automated haematology analysers offer precise haemoglobin measurements, but are expensive and impractical for field, point of care, primary care and remote settings use. The portable and cost-effective Hemocue device provides an alternative. Comparing their accuracies is crucial to prevent diagnostic discrepancies and misdiagnoses. This study aimed to determine the accuracy of Hb HemoCue machine by comparing its performance to automated analyser at Kilimanjaro Christian Medical Centre (KCMC) clinical laboratory where both equipment are used. Methodology: A cross-sectional study was conducted at KCMC Clinical Laboratory among adult patients whose haemoglobin concentrations were measured from May to June 2024. Haemoglobin levels were estimated using two distinct methods: Hb HemoCue machine and automated haematology analyser. Results: Haemoglobin (Hb) concentration values obtained from the HemoCue machine and the automated analyser, had a mean difference of 0.001 g/dL (95% Cl: -0.036 to 0.038), t value of 0.062, and a p-value of .95, indicating a non-statistically significant differences between the two measurement methods. The Bland-Altman plot analysis indicated that the mean difference (bias) between the two methods was 0.0012 g/dL, and the limits of agreement ranged from -0.481 to 0.482 g/dL, suggesting that the HemoCue machine tends to slightly overestimate Hb values compared to the automated haematology analyser. The Pearson correlation coefficient for the Hb concentrations measured using HemoCue and automated analyser was 0.995, indicating a very strong positive correlation. The HemoCue demonstrated a sensitivity of 98.3%, specifity of 90.4%, positive predictive value of 95.9% and a negative predictive value of 95.9%, indicating high performance accuracy of HemoCue in diagnosing anaemia. Conclusion: The study revealed strong agreement between HemoCue and automated haematology analyser for measuring haemoglobin concentrations. Both methods demonstrated high diagnostic accuracy suitable for clinical use. Although HemoCue slightly overestimated haemoglobin, this difference was deemed insignificant. The study endorses HemoCue as a reliable tool for haemoglobin concentration measurement alongside and in lack of automated analysers.