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首页> 外文期刊>Tropical Medicine and International Health: TM and IH >Evaluation of the diagnostic accuracy of the Haemoglobin Colour Scale to detect anaemia in young children attending primary healthcare clinics in Zanzibar
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Evaluation of the diagnostic accuracy of the Haemoglobin Colour Scale to detect anaemia in young children attending primary healthcare clinics in Zanzibar

机译：评估血红蛋白色标在桑给巴尔基层医疗所就诊的幼儿中发现贫血的诊断准确性

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Objectives This study evaluates the diagnostic accuracy of Haemoglobin Colour Scale (HCS), compared with clinical diagnosis, to detect anaemia and severe anaemia in preschool-age children attending primary healthcare clinics in rural Zanzibar. Methods In all participants, haemoglobin (Hb) concentration was independently estimated by clinical examination for palmar pallor, HCS and HemoCue?. HemoCue was considered the reference method. Data collection was integrated into the usual health services and performed by local healthcare workers (HCWs). Sensitivity, specificity, positive and negative predictive values were calculated for HCS and clinical examination for palmar pallor. The limits of agreement between HCS and HemoCue, and inter-observer variability for HCS, were also defined. Results A total of 799 children age 2-59months were recruited to the study. The prevalence of anaemia (Hb<11g/dl) and severe anaemia (<5g/dl) were 71% and 0.8% respectively. The sensitivity of HCS to detect anaemia was 33% [95% confidence interval (CI) 29-36] and specificity was 87% (83-91). The sensitivity of HCS to detect severe anaemia was 14% (95% CI 0-58) and specificity was 100% (99-100). The sensitivity of palmar pallor to detect anaemia was low, but superior to HCS (58%vs. 33%, P<0.001); specificity was inferior to HCS (55%vs. 87%, P<0.001). There was no evidence of a difference in either sensitivity (P>0.1) or specificity (P>0.1) between HCS and palmar pallor to detect severe anaemia. Conclusions Haemoglobin Colour Scale does not improve the capacity of HCWs to diagnose anaemia in this population. Accuracy is limited by considerable variability in the performances of test operators. However, optimizing the training protocol for those using the test may improve performance.
机译：目的本研究评估了血红蛋白色标（HCS）的诊断准确性，并与临床诊断进行了比较，以检测在桑给巴尔农村地区初级保健诊所就读的学龄前儿童的贫血和严重贫血。方法通过临床检查独立评估所有参与者的血红蛋白（Hb）浓度，以评估手掌苍白，HCS和HemoCue?。 HemoCue被认为是参考方法。数据收集已整合到常规医疗服务中，并由当地医护人员（HCW）执行。计算HCS的敏感性，特异性，阳性和阴性的预测值以及手掌苍白的临床检查。还定义了HCS和HemoCue之间的一致性限制，以及HCS的观察者间差异。结果共招募了799名2至59个月大的儿童。贫血（Hb <11g / dl）和严重贫血（<5g / dl）的患病率分别为71％和0.8％。 HCS检测贫血的敏感性为33％[95％置信区间（CI）29-36]，特异性为87％（83-91）。 HCS检测严重贫血的敏感性为14％（95％CI 0-58），特异性为100％（99-100）。手掌苍白对贫血的敏感性较低，但优于HCS（58％vs。33％，P <0.001）。特异性低于HCS（55％vs. 87％，P <0.001）。没有证据表明HCS和手掌苍白检测严重贫血的敏感性（P> 0.1）或特异性（P> 0.1）有所不同。结论血红蛋白色标不能提高该人群中HCW诊断贫血的能力。准确性受到测试操作员性能差异的限制。但是，为使用该测试的人员优化培训协议可以提高性能。

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