Reference Intervals for Commonly Requested Hematological Parameters in Adolescents Living in Kilifi County, Kenya
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Date
2020-11
Authors
Awino, Duncan
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Clinicians require hematological reference measure that they can use to compare with the results presented to them by laboratories in order to make medically correct decisions because Peoples’ laboratory sample analysis results are not the same. These reference measures are derived from a healthy group of people for each hematological parameter and can be affected by age, sex, previous exposure to environmental pathogens, genetic makeup, and nutritional status of individual, pregnancy, ethnicity, and altitude, the choice of various techniques, machines, and reference samples. Clinical Laboratory and Standards Institute approved guideline-third edition recommends that medical laboratories develop their own individual reference intervals from their local population they serve or carry out validation before effectively using the ones found from different regions. The objective of this study was to develop the hematological reference intervals for healthy adolescents living in Kilifi County, Kenya. 600 volunteers aged between 13 and 17 were recruited for this cross-sectional study. However, only 314 volunteers {52.3(%)} were enrolled, furthermore only 242 volunteers 40.3(%) got inclusion space in the final analysis to develop the hematological reference limits. Reference sample population was divided into two groups of 121 each based on gender to permit 95(%) confidence intervals to be non-parametrically enumerated in the establishment of lower and upper limit of the confidence intervals. The methods used for the electronic auto hematology analyzer were: Flow cytometry, colorimetric and electrical impedance. A medical statistical software was used to calculate, lowest and highest values, Median, Standard deviation, Arithmetic mean, Coefficient of kurtosis and Coefficient of Skewness. Mann-Whitney tests for independent samples, was used to find out if there were significant differences between the developed male and female hematological values in adolescents living in Kilifi. Statistically significant differences between females and males was accepted where ρ<0.05. This study determined Kilifi adolescents hematological reference values for twenty three commonly requested parameters in Hemoglobin concentration, Red blood cells count, Hematocrit levels, Red blood cells indices, White blood cells count and Platelet count, based on the blood analysis. Test for normal distribution indicated that: in males; out of the 23 parameters measured in 121 samples, 4.35% parameters were normally distributed whereas 95.65 (%) parameters were not normally distributed. In females, out of the 23 parameters measured in 121 samples: only 39.13 (%) parameters were normally distributed whereas 60.87 (%) parameters were not normally distributed. Based on gender, out of the 23 parameters analysed 39.13 (%) showed significant differences among males and females whereas 60.87 (%) showed comparable results. From the study findings, there were both comparable and significant differences between the developed hematological values in adolescents living in Kilifi County and the commonly used published data developed from Africa and other parts of the world. The established age and sex specific reference intervals for adolescents’ haematological parameters and their indices for Kilifi County, Kenya should be adapted for use in the Health Institutions within the county. In future, studies should also focus on paediatric and geriatric populations in Kilifi County, and other regions of Kenyan.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Medical Biochemistry) in the School of Pure and Applied Sciences of Kenyatta University, November, 2020
Keywords
Hematological Parameters, Adolescents, Kilifi County, Kenya