A Comparison of the Accuracy of Handheld Hemoglobinometer and Hematocrit Measurements for Detecting Plasma Leakage in Dengue Hemorrhagic Fever

Figures & data

Table 1 Characteristics of Observed Subjects with Plasma Leakage (Dengue Hemorrhagic Fever) versus Those with No Plasma Leakage (Dengue Fever)

Variable (n = 48)	DHF (n = 33)	DF (n = 15)	p-value
Sex, male	72.7%	46.7%	0.08^c
Age (years), median (IQR)	21 (18–33)	20 (15–35)	0.68^b
Fever day on admission, median (IQR)	4 (3–5)	4 (3–4)	0.53^b
Dengue confirmation test
Positive NS1 Dengue Rapid Test	28/32	13/14	1.00^d
Positive IgM Dengue Rapid Test	14/23	4/7
Positive IgG Dengue Rapid Test	13/23	3/7
Dengue Infecting Serotype
DEN1	2	0	0.40^c
DEN2	3	1
DEN3	11	9
DEN4	3	1
Inconclusive PCR	14	3
Plasma leakage (by ultrasound)
Pleural effusion	11	0
Ascites	10	0
Gallbladder thickening	33	0
Hb POCT (gr/dl) (mean ± SD)
On admission	15.6 ± 1.6	14.4 ± 1.3	0.01^a
Increased Hb (Delta) (%)	11.77 ± 9.1	7.96 ± 5.1	0.13^a
Ht (%) (Mean ± SD)
On admission	45.1 ± 4.2	41.5 ± 2.7	0.001^a
Increased Ht (Delta) (%)	12.18 ± 8.39	7.66 ± 4.93	0.02^a

Notes: Categorical data were presented as percentages. Continuous variables were presented using means (with standard deviations). Differences between groups were analyzed using ^aUnpaired t-test, ^bMann–Whitney test, ^cChi Square test, ^dFisher Exact test. A p-value <0.05 was consider significant.

Figure 1 The correlation between hemoglobin-point-of-care testing and hematocrit tests calculated using a simple linear regression.

Table 2 Accuracy of Various Methods for Assessing Hemoconcentration Using Optimal and 20% Increase Cutoff Points to Detect Plasma Leakage

	Cutoff	DHF N = 33	DF N = 15	Sensitivity (%)	Specificity (%)	AUC (95% CI for AUC)
At admission with optimal cutoff
Hemoglobin-POCT	>14.9 gr/dl	21	4	63.6	73.3	0.712 (0.563–0.834)
	≤14.9 gr/dl	12	11
Hematocrit	>43%	22	3	66.7	80.0	0.746 (0.600–0.861)
	≤43%	11	12
Delta value using optimal cutoff
Hemoglobin-POCT	>10.3%	15	3	45.5	80.0	0.615 (0.464–0.752)
	≤10.3%	18	12
Hematocrit	>10.8%	16	2	48.5	86.7	0.643 (0.492–0.776)
	≤10.8%	17	13
Delta value using 20% cutoff *
Hemoglobin-POCT	≥20%	6	0	18.2	100	Not applicable
	<20%	27	15
Hematocrit	≥20%	5	0	15.2	100	Not applicable
	<20%	28	15

Note: *WHO criteria 1997.

Abbreviations: DHF, dengue hemorrhagic fever; DF, dengue fever; AUC, area under curve; CI, confidence interval.