Background Automated hematology analyzers offer precise hemoglobin measurements, but are expensive and impractical for field, point of care, primary care and remote settings use. The portable and cost-effective Hemocue device provides an alternative. Comparing their accuracies is crucial to prevent diagnostic discrepancies and misdiagnoses. This study aimed to determine the accuracy of Hb HemoCue machine by comparing its performance to automated analyzer at KCMC clinical laboratory where both equipment are used.

Methods A cross-sectional study was conducted at Kilimanjaro Christian Medical Centre (KCMC) Clinical Laboratory among adult patients whose hemoglobin concentrations were measured in May to June 2024. Hemoglobin levels were estimated using two distinct methods: the Hb HemoCue machine and repeatedly tested using an automated hematology analyzer.

Results Hemoglobin (Hb) concentration values obtained from the HemoCue machine and the automated analyzer, had a mean difference of 0.001 g/dl (95% Cl: -0.036 to 0.038), t value of 0.062, and a p-value of 0.95, indicating a non-statistically significant differences between the two measurement methods. The Bland-Altman plot analysis indicated that the mean difference (bias) between the two methods was 0.0012 g/dL, and the limits of agreement ranged from - 0.481 to 0.482 g/dL, suggesting that the HemoCue machine tends to slightly overestimate Hb values compared to the automated hematology analyzer. The Pearson correlation coefficient for the Hb concentrations measured using HemoCue and automated analyzer was 0.995, indicating a very strong positive correlation. Receiver operating characteristics (ROC) curve showed that the area under the curve (AUC) for analyzer and HemoCue was 1.000 indicating that both methods have good diagnostic accuracy of measuring Hb concentrations.

Conclusion The study revealed strong agreement between HemoCue and automated hematology analyzer for measuring hemoglobin concentrations. Both methods demonstrated high diagnostic accuracy suitable for clinical use. Although HemoCue slightly overestimated hemoglobin, this difference was deemed insignificant. The study endorses HemoCue as a reliable tool for hemoglobin concentration measurement alongside automated analyzers.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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Kilimanjaro Christian Medical University College - College Research Ethics and Review Committee (KCMUCo-CRERC).

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