Comparison of Measurement of Hemoglobin Concentration by HemoCue 201 and HemoCue 301 with Sysmex Automated Hematology Analyzer among Nonpregnant Women of Reproductive Age Group (15–49 Years) in a Rural Area of Haryana

Background: Anemia is diagnosed based on the hemoglobin (Hb) concentration. Sysmex automated hematology analyzer is accepted as the gold standard technique. The introduction of a digital hemoglobinometer is an important addition of testing device under the Anemia Mukt Bharat program. Objectives: The objectives of this study were to determine the precision and validity of the digital hemoglobinometers in measuring Hb concentration among nonpregnant women of reproductive age who received intravenous iron sucrose (IVIS) for moderate anemia during pregnancy 6 and 12 months ago. Materials and Methods: Nonpregnant women of the reproductive age group were recruited from the IVIS register available at two primary health centers in rural Haryana. Paired capillary and venous blood samples were collected simultaneously for the estimation of Hb concentration by digital hemoglobinometers and hematology analyzer, respectively. Results: A total of 150 and 129 participants were included for measuring Hb concentration by HemoCue 201 and HemoCue 301, respectively. Both the digital hemoglobinometers underestimated the Hb concentration compared to the hematology analyzer. The bias (level of agreement) was −0.38 (−1.81–1.04) for HemoCue 201 and −0.15 (−1.19–0.89) for HemoCue 301 compared to hematology analyzer. Lin’s concordance coefficient was higher in HemoCue 301 (0.79) than in HemoCue 201 (0.68). Kappa statistics showed strong (0.81) and moderate (0.77) agreement for HemoCue 301 and HemoCue 201, respectively. Both digital hemoglobinometers showed excellent diagnostic precision (AUC of receiver operating characteristic: HemoCue 201: 0.92 [95% confidence interval (CI) 0.86–0.98], and for HemoCue 301: 0.92 [95% CI 0.86–0.97]). Conclusion: Both the digital hemoglobinometers had acceptable precision and validity. Therefore, either of these two digital hemoglobinometers could be used for the screening of anemia.