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Doucoure M, Zeguime A, Niangaly A, Guindo MA, Doritchamou JYA, Assadou MH, Katile A, Kanoute MB, Perou S, Ouattara A, Sanogo S, Ouologuem B, Traore S, Dao B, Dembele D, Kone M, Kamate B, Sissoko K, Sankare S, Diarra S, Dolo A, Sissoko MS, Hume JCC, Cook D, Healy SA, Gorres JP, Traoré B, Gamiel J, Duffy PE, Sagara I. Normal Clinical Laboratory Ranges by Age and Sex, and Impact on Study Screening Outcomes in Rural Mali. Am J Trop Med Hyg 2024; 110:1021-1028. [PMID: 38531104 PMCID: PMC11066370 DOI: 10.4269/ajtmh.23-0719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/04/2024] [Indexed: 03/28/2024] Open
Abstract
The interpretation of a laboratory test result requires an appropriate reference range established in healthy subjects, and normal ranges may vary by factors such as geographic region, sex, and age. We examined hematological and clinical chemistry parameters in healthy residents at two rural vaccine trial sites: Bancoumana and Doneguebougou in Mali, West Africa. During screening of clinical studies in 2018 and 2019, peripheral blood samples from 1,192 apparently healthy individuals age 6 months to 82 years were analyzed at a laboratory accredited by the College of American Pathologists for a complete blood count, and creatinine and/or alanine aminotransferase levels. Based on manufacturers' reference range values, which are currently used in Malian clinical laboratories, abnormal values were common in this healthy population. In fact, 30.4% of adult participants had abnormal neutrophil levels and 19.8% had abnormal hemoglobin levels. Differences by sex were observed in those who were older, but not in those younger than 10 years, for several parameters, including hemoglobin, platelet, and absolute neutrophil counts in hematology, and creatinine in biochemistry. The site-specific reference intervals we report can be used in malaria vaccine clinical trials and other interventional studies, as well as in routine clinical care, to identify abnormalities in hematological and biochemical parameters among healthy Malian trial participants.
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Affiliation(s)
- M’Bouye Doucoure
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Merepen A. Guindo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Justin Y. A. Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mahamadoun H. Assadou
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Katile
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Moussa B. Kanoute
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sidiki Perou
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Adama Ouattara
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sintry Sanogo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Boucary Ouologuem
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Souleymane Traore
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Bakary Dao
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Drissa Dembele
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Mamady Kone
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Bourama Kamate
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Kourane Sissoko
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Seydou Sankare
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sadio Diarra
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Amagana Dolo
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Mahamadou S. Sissoko
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Jennifer C. C. Hume
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - David Cook
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Sara A. Healy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - J. Patrick Gorres
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Boubacar Traoré
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Jordyn Gamiel
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Issaka Sagara
- Malaria Research and Training Center, International Center for Excellence in Research–MALI, University of Sciences, Techniques and Technologies of Bamako, Mali
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Fiseha T, Alemayehu E, Mohammed O, Gedefie A, Adamu A, Tamir Z, Gebreweld A. Reference Intervals of Haematological Parameters for Apparently Healthy Adults in Northeast Ethiopia. Int J Gen Med 2023; 16:5309-5321. [PMID: 38021065 PMCID: PMC10660733 DOI: 10.2147/ijgm.s430751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background Clinical laboratory reference intervals play a vital role in evaluating overall well-being, tracking the progression of diseases, and detecting potential harmful effects and complications. Despite evidence revealing disparities, many African nations currently rely on reference intervals for blood analysis obtained mainly from Western populations. This practice increases the risk of misidentifying and misdiagnosing healthy individuals. The aim of this study was to establish common hematological parameters reference intervals for healthy adults in Northeast Ethiopia. Methods This community-based cross-sectional study consisted of 328 individuals who were presumed to be in good health. To assess their blood-related characteristics, blood samples were collected and analyzed using the advanced Dirui BF-6500 analyzer, along with serological testing. In accordance with guidelines provided by the Clinical and Laboratory Standards Institute, the study employed a non-parametric approach to calculate the medians and 95% confidence intervals. To explore potential variations between males and females, a statistical test known as the Mann-Whitney U-test was used to compare the reference intervals. Results The established reference intervals were: white blood cells 3.5-11.3×109/L; red blood cells 4.0-6.1×1012/L; hemoglobin 11.2-17.5g/dL; hematocrit 35.4-52.0%; MCV 77.9-93.8fl; MCH 24.7-32.0pg; MCHC 306-349g/L; RDW-CV 12.1-13.8% and platelet 131-391×109/L. The reference values of monocytes, eosinophils, red blood cells, hemoglobin, hematocrit and RDW-CV in males were higher than females, while females had significantly higher platelet counts compared to males. The reference intervals discovered differed from the reference intervals now in use, those mentioned in earlier research in Ethiopia or other African nations, as well as those conducted on Western populations. Conclusion In the adult demographic of Northeast Ethiopia, specific reference intervals for commonly observed hematological parameters were established, tailored to the local community. Consequently, these reference intervals hold the potential to enhance informed decision-making within this population, by providing valuable guidance when interpreting laboratory test outcomes.
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Affiliation(s)
- Temesgen Fiseha
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aderaw Adamu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zemenu Tamir
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Angesom Gebreweld
- Department of Medical Laboratory Science, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Alkhaldy HY, Awan ZA, Abouzaid AA, Elbahaey HM, Al Amoudi SM, Shehata SF, Saboor M. Effect of Altitude on Hemoglobin and Red Blood Cell Indices in Adults in Different Regions of Saudi Arabia. Int J Gen Med 2022; 15:3559-3565. [PMID: 35386861 PMCID: PMC8979750 DOI: 10.2147/ijgm.s358139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Complete blood count (CBC) is a commonly used blood test for health checks. This study was conducted to compare CBC from two different altitudes and from sea-level populations in order to suggest correction factor for altitude-related increment on the hemoglobin and red blood cell indices. Patients and Methods In this retrospective lab records study, large datasets of CBCs over 5-year period were screened from three different regions of Saudi Arabia, Jeddah (a coastal city), Taif City located at 1879 m above sea level, and Abha City at located 2270 m above sea level. Descriptive analysis and significance testing of the CBC variables at different altitude were compared. Results A total of 57,059 participants were included for final analysis. Mean hemoglobin (Hb) concentration (g/dL) was 14.81 for men and 13.77 for women at sea level, whereas Hb concentrations were 15.35 and 14.19 for men and women residing at Taif City, respectively, and 15.40 and 14.71 for men and women at Abha City, respectively. Hemoglobin and other red cell indices were significantly different among men and women across different altitude, except for mean corpuscular volume (MCV). The MCV 95th percentile range was lower at sea level and both altitudes as compared to current reference range (76-91 fL vs 81-98 fL). Conclusion Although altitude-associated increment in Hb concentration was evident in both men and women, it was lower than as suggested by World Health Organization and Centers for Disease and Control. Results of this study can also be used to derive new CBC reference intervals for Saudi residents living at high altitude. A correction factor (ΔHb) of 0.30 g/dL per 1000 m altitude is suggested to be used in adult population living at high altitudes in Saudi Arabia which should help better define anemia and polycythemia at altitude.
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Affiliation(s)
- Husain Y Alkhaldy
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,Research Center for Advanced Materials Science, King Khalid University, Abha, Saudi Arabia
| | - Zuhier A Awan
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia
| | - Ahmed A Abouzaid
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia.,Department of Medical Biochemistry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hossameldin M Elbahaey
- Department of Clinical Pathology, Al-Borg Medical Laboratories, Jeddah, Saudi Arabia.,Clinical Pathology Department, Suez Canal University, Ismailia Governorate, Egypt
| | - Saeed M Al Amoudi
- Department of Medical Biochemistry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Shehata F Shehata
- Department of Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.,High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Muhammad Saboor
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.,Medical Research Center, Jazan University, Jazan, Saudi Arabia
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