Complete blood count reference intervals from a healthy adult urban population in Kenya

Abstract

BackgroundThere are racial, ethnic and geographical differences in complete blood count (CBC) reference intervals (RIs) and therefore it is necessary to establish RIs that are population specific. Several studies have been carried out in Africa to derive CBC RIs but many were not conducted with the rigor recommended for RI studies hence limiting the adoption and generalizability of the results.MethodBy use of a Beckman Coulter ACT 5 DIFF CP analyser, we measured CBC parameters in samples collected from 528 healthy black African volunteers in a largely urban population. The latent abnormal values exclusion (LAVE) method was used for secondary exclusion of individuals who may have had sub-clinical diseases. The RIs were derived by both parametric and non-parametric methods with and without LAVE for comparative purposes.ResultsHaemoglobin (Hb) levels were lower while platelet counts were higher in females across the 4 age stratifications. The lower limits for Hb and red blood cell parameters significantly increased after applying the LAVE method which eliminated individuals with latent anemia and inflammation. We adopted RIs by parametric method because 90% confidence intervals of the RI limits were invariably narrower than those by the non-parametric method. The male and female RIs for Hb after applying the LAVE method were 14.5–18.7 g/dL and 12.0–16.5 g/dL respectively while the platelet count RIs were 133–356 and 152–443 x103 per μL respectively.ConclusionConsistent with other studies from Sub-Saharan Africa, Hb and neutrophil counts were lower than Caucasian values. Our finding of higher Hb and lower eosinophil counts compared to other studies conducted in rural Kenya most likely reflects the strict recruitment criteria and healthier reference population after secondary exclusion of individuals with possible sub-clinical diseases.

Full blood count and white cell differential count reference ranges obtained from a healthy urban South African population residing in the Western Cape of South Africa

“…These results support others who have reported similar results in healthy African individuals . A recent study, also forming part of the C‐RIDL project and carried out on healthy urban Kenyans, proposed a neutrophil reference interval of 1.05‐4.08 × 10 9 /L which is very similar to the values observed in the black African population of this current study . These reports have all proposed separate reference ranges for Africans, which is important, as they could influence clinical decision‐making, especially in the field of oncology and the initiation of chemotherapy.…”

“…In addition, the strict guidelines of the Committee on Reference Intervals and Decision Limits (C‐RIDL) were followed ensuring that only healthy individuals were included. This ensures that the results can be compared with other countries participating in the international multi centre project . A limitation of this research was however the lower number of African volunteers in comparison with Caucasians.…”

“…This ensures that the results can be compared with other countries participating in the international multi centre project. 16 A limitation of this research was however the lower number of African volunteers in comparison with Caucasians. In addition, we did not investigate the presence of haemoglobinopathies which might explain the differences observed in the red cell indices.…”

“…4,5,8,14,15 A recent study, also forming part of the C-RIDL project and carried out on healthy urban Kenyans, proposed a neutrophil reference interval of 1.05-4.08 × 10 9 /L which is very similar to the values observed in the black African population of this current study. 16 These reports have all proposed separate reference ranges for Africans, which is important, as they could influence clinical decision-making, especially in the field of oncology and the initiation of chemotherapy. The results of this current study also support previous reports 4,5 which observed monocyte and basophil counts as being lower in Black African participants but are in contrast to other African studies which have reported higher monocyte and eosinophil counts.…”

Trends and Adaptive Optimal Set Points of CD4+ Count Clinical Covariates at Each Phase of the HIV Disease Progression

“…During these two phases, the optimal set point for the platelet count was observed to be approx. >450 × 10 9 /L, which was higher than the normal reference range of 178-454 × 10 9 /L [86,87]. e general increase in the CD4 + cells in response to the tissue oxygenation, based on haematocrit and MCV, was also observed in a study by Vanisri and Vadiraja [20].…”