Immediate assessment of HbA1c under field conditions in Tanzania

In Tanzania, assessment of blood glucose is the most frequently used method for evaluating glycaemic control in diabetic patients. The patients' metabolic control is often poor and the determination of glycated haemoglobin (HbA1c) for long-term control could be a valuable tool to better manage the treatment. The aim of this study was to determine whether an immediate assessment method for HbA1c (DCA 2000 analyzer) gives reliable results in the warm and moist climate of east Africa. The study was performed in two parts. One equipment test in Sweden where blood samples from 65 diabetic patients were analysed in a DCA 2000 kept at room temperature and in another kept in a climate chamber. The samples were also analysed with HPLC as a reference method. In the second part HbA1c was analysed in 159 Tanzanian diabetic patients with a DCA 2000 and with HPLC combined with a filter paper technique (HbA1c via Post). The study showed that the DCA 2000 gives reliable results at 85% humidity and a temperature not exceeding +31 degrees C. The correlation with the HPLC analysis varied between 0.94 and 0.98. The conclusion is that the DCA 2000 analyzer can be used in Tanzania during the winter but has to be placed in an air-conditioned room if the temperature exceeds +31 degrees C.