Diagnostic performance of capillary hemoglobin screening for iron deficiency among blood donors

Blood donors have a tendency towards iron deficiency. Iron deficiency detection in donors is not a routine procedure in Indonesia. Capillary hemoglobin (Hb) screening is used to select healthy donors, requiring Hb levels above 12.5 g/d. However, there were few studies evaluating the diagnostic performance of predonation hemoglobin screening for detecting iron deficiency in regular blood donors. The aim of this study is to evaluate the diagnostic performance of predonation Hb capillary to detect iron deficiency among blood donors. This cross-sectional study was performed at the Indonesian Red Cross of  Yogyakarta for 3 weeks. Participants were people who met the blood donor’s criteria including capillary Hb level 12.5 gr/dL. Participants were divided into iron deficiency and normal iron storage group based on ferritin level. Receiver Operating Characteristic analysis was performed to evaluate the diagnostic performance of predonated capillary hemoglobin with serum ferritin 15 ng/mL as reference for iron deficiency. This study enrolled 137 participants who met the criteria, male predominance (73.7%). The ROC analysis of hemoglobin for detecting iron deficiency showed an Area Under Curve of 0.696 (95% CI: 0.611-0.771) for  cut-off 12.5 g/dL had sensitivity 6.06% and specificity 99.04%. Capillary Hb screening showed moderate diagnostic accuracy with high specificity but low sensitivity at the standard cut-off. The Hb cut-off 12.5 gr/dL has low sensitivity, and it needs to be increased or combined with the others hematological parameters.