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Abstract
Background: Anaemia in pregnancy is a significant public health problem in Nigeria. Accurate diagnosis in resource-poor settings is challenging due to the cost and technical demands of standard laboratory methods. The Haemoglobin Colour Scale (HCS) is a simple, inexpensive point-of-care tool that requires no electricity, but its validity in clinical practice needs evaluation.
Objective: This study aimed to determine the validity of the HCS against the haematocrit method for screening anaemia among pregnant women in Keffi, Nigeria.
Methods: A facility-based analytical cross-sectional study was conducted among 196 pregnant women attending the booking antenatal clinic at Federal Medical Centre, Keffi. Participants were systematically selected. Capillary blood was used for HCS assessment by researcher, and venous blood was collected for haematocrit determination by a laboratory scientist. Sensitivity, specificity, predictive values, and diagnostic accuracy of HCS were calculated at haemoglobin cut-offs of <11.0g/dl, <10.0g/dl, and <7.0g/dl using haematocrit as the gold standard.
Results: The prevalence of anaemia (Hb <11.0g/dl) was 43.9%. At Hb <11.0g/dl, HCS had sensitivity of 100% and specificity of 15.45%. At Hb <10.0g/dl, sensitivity was 95.00%, specificity 83.33%, and diagnostic accuracy 85.71%. At Hb <7.0g/dl, sensitivity was 75.00%, specificity 100.00%, and accuracy 99.49%. A history of vomiting in current pregnancy was an independent predictor of anaemia (OR=2.51, p=0.005).
Conclusion: The Haemoglobin Colour Scale demonstrated high sensitivity for detecting any anaemia and excellent diagnostic accuracy for identifying moderate-to-severe anaemia (Hb<10.0g/dl). It is a valid and useful screening tool for anaemia in pregnancy, particularly in resource-poor settings where advanced technology is unavailable.
References
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