Assessment of the diagnostic performance of TrueHb® point-of-care hemometer compared with Sysmex i3 analyzer among patients at International Hospital Kampala, Uganda

Ivan Mugisha Taremwa,1 Ivan Ndeze,1 Bashir Mwambi,1 Christine Atuhairwe,2 Diana Inda Achieng,3 Bernard Natukunda41Department of Medical Laboratory Sciences, Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda; 2Institute of Public Health and Management, Clarke International University, Kampala, Uganda; 3Lancet Laboratories, Kampala, Uganda; 4Department of  Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, UgandaAim/Objective: To assess the diagnostic performance of TrueHb® point-of-care (POC) hemometer compared with Sysmex i3 analyzer at International Hospital Kampala, Uganda.Materials and methods: We analyzed ethylenediaminetetraacetic acid blood samples to estimate hemoglobin (Hb) levels using parallel testing with TrueHb® hemometer and Sysmex i3 analyzer. Data were analyzed to ascertain the diagnostic performance of the test assays using the Bland and Altman method. Sensitivity, specificity, positive and negative predictive values were calculated.Results: The study enrolled 402 patients; of these, 156 (38.8%) were males. The average Hb levels were 8.7±1.8 and 13.3±2.6 g/dL for the anemic and nonanemic patients, respectively. One hundred and fifty-five participants were anemic, giving anemia prevalence of 38.56% (95% CI: 35.17–40.38). The mean difference of the TrueHb® and Sysmex i3 assays was 2.2219 (SD 1.07915), and the two devices did not show a difference in their measurements (t=−2.407, p-value 0.017, 95% CI: −0.095–0.010). Further, they showed a significant level of agreement (t=41.281; 95% CI: 2.1161–2.3277) and intraclass correlation coefficients (ICC=0.793). The sensitivity, specificity, positive and negative predictive values were 100.00%, 51.01%, 55.16% and 100.00%, respectively. The average performance turnaround time (TAT) for the TrueHb® hemometer was 2.46 mins (95% CI: 2.37–2.55).Conclusion: TrueHb® POC hemometer is an accurate POC for Hb estimation with a good performance agreement with the Sysmex i3 analyzer. This, coupled with its utility aspects, makes it a good diagnostic tool in a high anemia burden and low-resource setting.Keywords: anemia, hemoglobin estimation, point-of-care testing, TrueHb®, Sysmex i3, Ugand