Background: Automated haematology analysers offer precise haemoglobin 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 analyser at Kilimanjaro Christian Medical Centre (KCMC) clinical laboratory where both equipment are used. Methodology: A cross-sectional study was conducted at KCMC Clinical Laboratory among adult patients whose haemoglobin concentrations were measured from May to June 2024. Haemoglobin levels were estimated using two distinct methods: Hb HemoCue machine and automated haematology analyser. Results: Haemoglobin (Hb) concentration values obtained from the HemoCue machine and the automated analyser, 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 .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 haematology analyser. The Pearson correlation coefficient for the Hb concentrations measured using HemoCue and automated analyser was 0.995, indicating a very strong positive correlation. The HemoCue demonstrated a sensitivity of 98.3%, specifity of 90.4%, positive predictive value of 95.9% and a negative predictive value of 95.9%, indicating high performance accuracy of HemoCue in diagnosing anaemia. Conclusion: The study revealed strong agreement between HemoCue and automated haematology analyser for measuring haemoglobin concentrations. Both methods demonstrated high diagnostic accuracy suitable for clinical use. Although HemoCue slightly overestimated haemoglobin, this difference was deemed insignificant. The study endorses HemoCue as a reliable tool for haemoglobin concentration measurement alongside and in lack of automated analysers.
Kehongo Moses Nyanguru, Ephantus G. Ndirangu, Robi Chacha, Bakari Chaka, J. O. Moody, Elizabeth Kigondu
East Africa Science · 2025-05
Abstract
Background: Tuberculosis (TB) remains a significant global health burden, exacerbated by increasing multidrug resistance. Medicinal plants, such as Albizia zygia (DC.) J.F. Macbr, is being used in Kenya to manage TB symptoms; however, antimycobacterial potential remains scientifically underexplored. Methods: The root bark of A. zygia was sequentially extracted using hexane, dichloromethane, ethyl acetate, methanol, and water. Antimycobacterial activity against Mycobacterium smegmatis was assessed using the Microplate Alamar Blue Assay (MABA). Cytotoxicity was evaluated via the MTT assay on Vero cells, and synergistic interactions with rifampicin (RIF) were determined using a checkerboard assay. GC-MS was employed for phytochemical profiling, followed by molecular docking against Mycobacterium tuberculosis targets (pks13 and EthR) using Schrödinger 2023. ADME/T properties were also predicted using in silico studies. Results: Methanol and aqueous extracts showed antimycobacterial activity with MIC₉₉ values of 625 μg/mL and 2500 μg/mL, respectively, and were non-cytotoxic (CC₅₀ >1000 μg/mL), except for the moderately cytotoxic dichloromethane extract. Synergistic and additive interactions with RIF were observed with FICI of 0.5 and 0.63, respectively. GC-MS identified 42 compounds; among which 7-ethyl-quinoline, diphenyl sulfone, hexa-decanoic acid, and 2,4-di-tert-butylphenol have been reported to exhibit antimycobacterial activity, also showed strong binding affinities (d-score ≥ -7.0 kcal/mol) to the multidrug resistance TB protein targets, Pks13 and EthR, suggesting their potential contribution to the observed antimycobacterial effects. ADME/T predictions indicated good oral bioavailability but raised concerns about CYP interactions and short terminal half-lives. Conclusion: A. zygia root bark contains bioactive phytochemicals with promising antimycobacterial activity and synergism with rifampicin. These findings validate the ethnomedicinal use of A. zygia in TB management in Kenya; therefore, further in vivo evaluation and pharmacokinetic optimization of lead compounds are needed.
MeSH terms
- Antimycobacterial
- ADME
- Andrographis paniculata
- Phytochemical
- Mycobacterium tuberculosis
- Resazurin
- Isoniazid
- Pharmacology
- Chemistry
- Tuberculosis
- Traditional medicine
- Medicine