Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.
Introduction:The objective of the study was to evaluate the performance of the Abbott Alinity hq advanced multi angle polarized scatter separation (MAPSS TM )based optical RBC technology, for the differentiation between iron deficiency anemia (IDA) and β-thalassemia carrier status.Methods: Four hundred and sixty-four samples were analyzed. 228 were healthy controls, 30 were β-thalassemia carriers, and 40 were IDA. Receiver operating characteristics analysis evaluated the performance of red cell parameters and mathematical formulas.Results: RBC concentration was the most efficient discriminant (area under the curve; AUC of 0.963, Youden Index of 0.88) followed by red blood cell distribution width in size distribution (AUC of 0.960 and YI of 0.86), and red blood cell distribution width coefficient of variation (AUC of 0.924, and YI of 0.74). The absolute reticulocyte concentration showed good diagnostic efficiency, with AUC of 0.808. Hemoglobin distribution width, the %CV of directly measured cellular hemoglobin concentration, and CHCr, the average hemoglobin concentration of reticulocytes have emerged as novel discriminating parameters, with AUC of 0.749 and 0.785, respectively.The England and Fraser index was the best discriminating mathematical formula based on Youden Index of 0.91. The Ricerca, red blood cell distribution width index, Green and King, and Mentzner Index formulas also showed strong discriminative power. The Shine and Lal index, together with the recent mathematical formula M/H, (ratio of percent microcytic and hypochromic red blood cells) demonstrated moderate performance with AUC of 0.796 and 0.740, respectively.
Conclusion:Extended red cell analysis delivered by the advanced optical technology on the Alinity hq hematology analyzer has efficient diagnostic utility in the initial discrimination of the two most common microcytic anemias: IDA and β-thalassemia trait.
Impedance technology has previously been demonstrated to overestimate platelet (PLT) count in samples with microcytosis. [1][2][3][4][5] The most frequent causes of microcytosis are iron deficiency, thalassemia syndromes, and anemia of chronic disease. Tantanate et al 3 . demonstrated that the impedance PLT count by Sysmex XN (PLT-I) showed poor correlation with the International Reference method (IRM), due to high-positive bias and low specificity for the diagnosis of thrombocytopenia, while the optical and fluoresce PLT counts were comparable to the IRM in patients with thalassemia. Several other studies have also concluded that optical or fluorescence-optical
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