Reflection on the paraclinical diagnosis of anemia

A round table discussion took place on Thursday 25 April 2019 at the headquarters of the CCSC-asbl on the paraclinical diagnosis of anaemia in the DRC. It brought around the table about ten people: seven  executives of the Health Laboratories Directorate, including its Director, Mr Malaba Munyandi, the Director of the Studies and Planning Directorate, Dr Alain M. Iyeti, a representative of INRB, Prof. Pierre Mukadi, a Nurse Titulaire d’un centre de santé urbano-rural, as well as the three experts from the CCSC-asbl.

paraclinical diagnosis of anemia
Round table discussion on the paraclinical diagnosis of anemia

The objectives of this round table were to: (i) Present the Policy Note prepared by the CSCC-asbl on paraclinical diagnosis of anemia in under-equipped environments with related evidence-based recommendations; (ii) Discuss the relevance of the recommendations, their acceptability as options to be considered by the stakeholders involved (decision-makers, providers); their feasibility (cost, infrastructure, HR, workload, etc.); (iii) Obtain the expression of willingness of decision-makers to implement these recommendations.

Round table discussion on the paraclinical diagnosis of anemia

After a very open and lively discussion, we can remember what which follows:

(i) The relevance of the recommendations made in this note from there is no doubt about it. Anemia remains a major health problem public in the DRC. Have diagnostic tests with a report acceptable cost-effectiveness at the level of health facilities in the areas of health is a concern at the level of the Ministry of Health.

(ii) The Sahli method appears to be more widely used in the field than in the Tallquist method. They both offer acceptable performance in terms of sensitivity and specificity. They can therefore be Recommendable in the short and medium term for health facilities (FOSA) on the front line. To minimize their disadvantages, these methods require users to provide prior training, training and regular supervision, an optimal workload and an improvement of the working environment.

(iii) At the level of the general reference hospitals, the cyanmethemoglobin is preferable, followed by hemocue. In all the In such cases, hospitals should be better equipped. The measurement of hemoglobin does not alone is not enough to better diagnose anemia. We have also needed is the red blood cell count and the measurement of hematocrit to estimate erythrocyte indices. As for the health facilities of At the front line, hospital lab technicians must be trained to the use of each method, supervised regularly, have a responsibility of optimal work and a work environment conducive to the activities of health laboratory.

(iv) In the long term, all subjective methods of diagnosing anemia should be banned and more precise quantitative methods should be adopted. The Government should commit itself to this with the support of its development partners.

(v) To move forward, the Health Laboratory Directorate has undertaken to approach the Research and Planning Department, which is preparing the SARA survey, in order to integrate into the tools that will be used to this investigation of the elements that will also make it possible to assess the state of the availability of the various diagnostic tests for anemia in health facilities. This is an important step in planning the acquisition of tests and the mobilization of the necessary resources from the Government and development partners.

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