Reference Ranges for Triage Room, Biochemical, Hematological and Tumour Marker Parameters for Taita-Taveta County, Kenya
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Date
2023
Authors
Gitimu, Richard
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Medical diagnosis is based on information from findings such as the medical history of the client, physical examination, self-report and interviews with the patient’s relative or both clinical reports from laboratory tests and radiologic studies. To assess one’s health status, different parameters are analysed progressively, and the generated reports are used to make a medical decision on the health status of the patients. Thus vital signs and laboratory report test results must be reported along with reference ranges. Little has been done to establish reference ranges for different populations in Kenya. Laboratory interpretation of test results with appropriate precision and accuracy for diagnostic purposes requires reference ranges or cutoff values. This study was a comprehensive determination of reference ranges for vital signs, hematology, clinical chemistry; cancer markers apparently from a healthy volunteer coastal population; vital parameters (for ages 4-93 years were 191 males and 317 females), body mass index (125 males and 127 females) pregnant women (296), infants, children, adolescents (males 129 and 132 females) and the geriatric (males 153 and 177 females), random blood sugar (131 males and 175 females), thyroid profile (124 males and 120 females) from which a total of 2390 subjects were recruited. Biochemistry analysis for liver, kidney function tests, lipid profile and electrolytes were analyzed using intergra 400 chemistry autoanalyzer. Tumour marker samples for the elderly population were analyzed using Chemwell auto analyzer (Biomerieux, Lyon, France), a closed system machine used to analyze tumor makers. The glucometer (On-call Plus, glucose meter from Roche Diagnostics GmbH, Mannheim, Germany) was used for random blood glucose analysis. All data were expressed as median and 2.5-97.5 %interval. Subsequently, independent-sample t-tests were performed to identify significant differences between the data of the males and the females. An analysis of variance (ANOVA) was performed for clinical chemistry, hematology and special chemistry parameters, with sex as a factor and age as covariate. Statistical significance was reached in the case of ρ < 0.05. The results were expressed as mean ± SD. Statistical Package for Social Science version 20 statistical software was used for data analysis.
The study established combined male and female reference ranges for vital signs, biochemical, and hematological for children, adolescents, pregnant mothers and the geriatric population of the Taita Taveta community. The study reported statically differences in EOS (%), NEU (x109/L), BAS (x109/L), HB (g/dL), MCV (fL), PLT and CA for infants, children and adolescents by gender. ALP (U/L), D-BIL, CREAT, NA, UA and PVC for pregnant mothers per trimester. For geriatric population, the difference was recorded by gender in NEU (%), LMP (%), ALT (U/L), T-BIL, CREAT, CA19-9 and CEA. The study also compared established reference ranges by age and what is published in medical books and similar research works where differences were reported in ALP (U/L), AST (U/L), HB (g/dL), PVC (%) and MCV (fL) by age. At the same time, PSA, CA15-3 and CA 125 were recorded by gender. The present study was the first to report hematology analysis, serum biochemistry, tumor/ cancer markers and vital signs reference ranges for selected categories in Kenya and one of very few such studies in Africa different from those in use in the local health facility. Since there was a statistical difference in gender and age, both the sex and age of a patient must be considered when analyzing different patient samples. This will help improve on management and can be adapted for caregiving to the people of Taita-Taveta County in addition to setting a bench for future research works
Description
A Thesis Submitted in Fulfillment of the Requirements for the Award of the Degree of Doctor of Philosophy in Medical Biochemistry of Kenyatta University January, 2023
Keywords
Reference Ranges for Triage Room, Biochemical, Hematological, Tumour Marker Parameters, Taita-Taveta County, Kenya