Hb 201 analyzer

Before praziquantel administration, finger-prick blood (100 µL) was collected to measure hemoglobin concentration (Hb conc) in g/dL using the HemoCue Hb 201+ analyzer (HemoCue AB Angelholm, Sweden) [40 (link)]. A child was defined as anemic if the Hb conc was less than 11.5 g/dL [41 ]. Anthropometric measurements were used to assess the nutritional status of the children. Bodyweight was measured in kilograms (kg), and height was measured in centimeter (cm). Body mass index (BMI) was calculated as a ratio of body weight (in kg) to height square (in meters). To assess for stunting and wasting, the anthropometry were converted to Z scores as height for age Z score (HAZ) and body mass index (BMI) for age Z score (BAZ) using the WHO Anthro-Plus software version 1.0.4 (Department of Nutrition, WHO, Avenue Appie, Geneva, Switzerland) [42 ]. All children with HAZ and BAZ scores less than two standard deviations were considered stunted and wasted, respectively.

Peripheral finger-prick blood was used to determine hemoglobin level by using HemoCue Hb 201+ analyzer (HemoCue AB Angelholm, Sweden). Anemia was defined when the maternal hemoglobin level was <11 g/dL. Mild, moderate, and severe anemia was defined when maternal Hb level was 10–10.9 g/dL, 7–9.9 g/dL and <7 g/dL, respectively [43 ]. Fetal anemia was defined when the cord blood Hb was <12.5 g/dL [44 (link)].

Baseline (BL) and endline (EL) MNP intervention of the child’s health was assessed (including axillary temperature), and a capillary blood sample of 500µL from the finger or heel was taken into a 0.5 mL ethylene diamine tetra-acetic acid (EDTA) tube. A HemoCue Hb 201⁺ analyzer (HemoCue AB, Angelholm, Sweden) was used to measure haemoglobin levels, and children found to be severely anaemic (Hb < 70 g/L) were immediately referred. The Malaria Rapid Diagnostic Test (RDT) (Paracheck Pf Unit, Orchid Biomedical Systems Verna, Goa, India) was performed quickly in the field, and a 3-day course of treatment was given to those who tested positive for malaria. They were only enrolled later upon recovery if any other eligibility requirements had been met. The remaining sample was transferred to the haematological, malaria microscopy and immunogenetic testing laboratory.
During the MNP intervention period and at six-month follow-up, children found to be febrile (i.e., axillary temperature > 37.5 °C) or have had a fever in the past 48 h were, blood sampled of 100μL in 0.5 mL EDTA for haematological and malaria tests. Anthropometric, socioeconomic, demographic, adherence to MNP intervention, insecticide-treated bed net use and participants' morbidity data were collected during the study as previously described in details elsewhere [22 (link), 23 (link)].

Hgb level was determined using a portable hemoglobin spectrophotometer (the HemoCue Hb 201 Analyzer (HemoCue, Angelholm, Sweden) and a specially designed microcuvette (the HemoCue Hb 201 Microcuvette, HemoCue, Angelholm, Sweden). Then, anemia was defined as Hgb level less than 11 g/dl [17 ].