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The assessment of anemia in a clinical setting begins with careful history taking and a detailed physical examination. The patient’s medical history should include questions about history of anemia symptoms such as fatigue or malaise, bleeding (in particular, gastrointestinal or heavy menstrual bleeding), family history of genetic disorders, current medication use, living in or travel to malaria endemic areas or areas affected by other anemia-causing infectious diseases, and diet history.

Anemia prevalence in a population is determined by the percentage of individual cases below a recommended reference value of the hemoglobin (Hb) concentration. The primary method for assessing anemia is through measuring hemoglobin and comparing the value to set thresholds based on age, sex, and physiological status (pregnancy, lactation, etc.).

Hemoglobin concentration in the blood is measured either by automated hematological analyzers or portable devices that use the principles of spectrophotometry like the HemoCue Hb device (HemoCue®, Angelholm, Sweden).The best practices for anemia assessment include use of venous (or potentially pooled capillary blood) for hemoglobin analysis by an automated analyzer or point-of-care Hemocue® device and adjusting hemoglobin concentration for altitude and smoking status using the age- and sex-specific and physiologically-validated cutoffs recommended by the World Health Organization.

Among other preanalytical factors (temperature and humidity of the environment, posture of the patient, specimen transport and storage, etc.), the mode of blood collection (venous or capillary, single-drop, or pooled capillary blood) affects hemoglobin measurements in different contexts. Discrepancies in the determination of hemoglobin concentrations could have a substantial effect on the estimation of anemia prevalence, especially in population surveys.

We found 43 resource(s)

In Search of Better Anemia Estimates: USAID Advancing Nutrition’s HEmoglobin MEasurement (HEME) Project
Webinar published by USAID Advancing Nutrition in
At the population level, differences in mean hemoglobin and the distribution of hemoglobin values can result in inaccurate and unreliable estimates of anemia prevalence .
Hidden No More: New Estimates Help the Nutrition Community Support Women and Children at Risk of Micronutrient Deficiencies
Journal Article published by USAID Advancing Nutrition in
Timely data on the burden of micronutrient deficiencies is essential to understanding what works where and whether we’re making progress. Researchers recently estimated the global and regional prevalence of deficiencies in one or more micronutrients among preschool-age children and non-pregnant women of reproductive age and bring transparency to…
Coffee and Chai Chat: Spotlighting New Global Data and Actions Needed on Hidden Hunger
Webinar published by Micronutrient Forum in
Experts discuss how to enhance data collection and identify the best sources of information, modeling methods used to derive estimates of micronutrient deficiencies and data gaps, hidden hunger among women, and priorities for action. This is a series of webinars.
Association between Hemoglobin and Elevation among School-aged Children: A Verification of Proposed Adjustments
Journal Article published by Am J Clin Nutr in
Hemoglobin increases with elevation as an adaptive response to lower blood oxygen saturation. This secondary data analysis examines the cross-sectional association between hemoglobin and elevation among school-aged children with data from nine population-based surveys. The paper calculates the hemoglobin adjustments required for each 500 meter…
Reticulocyte Haemoglobin Equivalent (RET-He) as an Early Marker of Responsiveness to Oral Iron Supplementation
Journal Article published by J Clin Pathol in
This study evaluated the analytical performance of reticulocyte hemoglobin equivalent as an early marker of responsiveness to iron supplementation in Cambodian women aged 18–45 years, who received 60 mg elemental iron for 12 weeks.
Diagnosing Anemia: Challenges Selecting Methods, Addressing Underlying Causes, and Implementing Actions at the Public Health Level
Literature Review published by Ann N Y Acad Sci in
This narrative review describes methods, equipment, and sample-related and quality control aspects of hemoglobin measurement for the diagnosis of anemia.
Drops of Capillary Blood Are Not Appropriate for Hemoglobin Measurement with Point-of-Care Devices: A Comparative Study Using Drop Capillary, Pooled Capillary, and Venous Blood Samples
Journal Article published by Nutrients in
This study aimed to estimate measurement errors in hemoglobin quantification in HemoCue 201+ using venous blood and capillary blood (both single-drop and pool) and compare the results against those of a reference method, which is venous blood analyzed in hematology analyzers.
Associations Between Type of Blood Collection, Analytical Approach, Mean Haemoglobin and Anaemia Prevalence in Population-Based Surveys: A Systematic Review and Meta-Analysis
Systematic Review published by J Global Health in
This study investigates whether differences in mean hemoglobin or prevalence of anaemia between near-in-time surveys of the same population were associated with differences in type of blood collection or analytic approach to hemoglobin measurement, using pairs of population-based surveys that measured hemoglobin in the same population of women of…