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

TITLE=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

JOURNAL=Frontiers in Global Women's Health

VOLUME=Volume 5 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2024.1427261

DOI=10.3389/fgwh.2024.1427261

ISSN=2673-5059

ABSTRACT=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.