Comparing hemoglobin distributions between population-based surveys matched by country and time

Daniel J. Hruschka, Anne M. Williams, Zuguo Mei, Eva Leidman, Parminder S. Suchdev, Melissa F. Young, Sorrel Namaste

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Valid measurement of hemoglobin is important for tracking and targeting interventions. This study compares hemoglobin distributions between surveys matched by country and time from The Demographic and Health Survey (DHS) Program and the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Methods: Four pairs of nationally representative surveys measuring hemoglobin using HemoCue® with capillary (DHS) or venous (BRINDA) blood were matched by country and time. Data included 17,719 children (6-59 months) and 21,594 non-pregnant women (15-49 y). Across paired surveys, we compared distributional statistics and anemia prevalence. Results: Surveys from three of the four countries showed substantial differences in anemia estimates (9 to 31 percentage point differences) which were consistently lower in BRINDA compared to DHS (2 to 31 points for children, 1 to 16 points for women). Conclusion: We identify substantial differences in anemia estimates from surveys of similar populations. Further work is needed to identify the cause of these differences to improve the robustness of anemia estimates for comparing populations and tracking improvements over time.

Original languageEnglish (US)
Article number422
JournalBMC public health
Issue number1
StatePublished - Mar 30 2020


  • Anemia
  • Biomarkers reflecting inflammation and nutritional determinants of Anemia
  • Blood collection
  • Data quality
  • Demographic and health surveys
  • Hemoglobin
  • Micronutrient surveys
  • Nutrition surveys

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Comparing hemoglobin distributions between population-based surveys matched by country and time'. Together they form a unique fingerprint.

Cite this