Local reference ranges for full blood count and CD4 lymphocyte count testing.

OBJECTIVE Recent advances in full blood count and CD4 technology, coupled with the changing population demographics of the Gauteng region, have necessitated reevaluation of the reference ranges currently in use. METHODS A cross-sectional study of 631 female and 88 male HIV-negative participants from the Gauteng region was performed. Full blood count, automated differential and CD4 count analyses were done using the latest internationally accepted technology. Reference ranges were compiled from the 2.5th and 97.5th percentiles for both male and female participant groups, and gender and ethnic comparisons calculated by non-parametric tests. RESULTS Results of 41 females were removed from the statistical analysis because their results were suggestive of possible anaemia. Full blood count reference interval comparison confirmed gender-specific differences in red blood cell and platelet parameters. Ethnic-specific differences were found for some red blood cell parameters in the black female cohort. In addition, black males and females both generally had lower neutrophil and higher lymphocyte counts than a combined Asian/Caucasian/coloured ethnic group. CONCLUSION Comparison of the currently calculated reference ranges with published data and reference values in use indicated that a separate ethnic-specific reference range should be introduced for the percentage/absolute neutrophil count and percentage lymphocytes. In addition, locally derived reference ranges for red cell distribution width (RDW) and CD4 percentage of lymphocytes should be implemented for routine diagnostic testing.

[1]  A. Kamali,et al.  Baseline Morbidity in 2,990 Adult African Volunteers Recruited to Characterize Laboratory Reference Intervals for Future HIV Vaccine Clinical Trials , 2008, PloS one.

[2]  G. Janossy,et al.  Large‐scale affordable Panleucogated CD4+ testing with proactive internal and external quality assessment: In support of the South African national comprehensive care, treatment and management programme for HIV and AIDS , 2008, Cytometry. Part B, Clinical cytometry.

[3]  Deborah K Glencross,et al.  A North American multilaboratory study of CD4 counts using flow cytometric panleukogating (PLG): A NIAID‐DAIDS Immunology Quality Assessment Program Study , 2008, Cytometry. Part B, Clinical cytometry.

[4]  Debbie Bradshaw,et al.  Estimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000. , 2007, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[5]  Jintanat Ananworanich,et al.  Predictors of disease progression in HIV infection: a review , 2007, AIDS research and therapy.

[6]  B. Coulibaly,et al.  Immunohematological Reference Values for Healthy Adults in Burkina Faso , 2007, Clinical and Vaccine Immunology.

[7]  J. Everhart,et al.  Prevalence of Neutropenia in the U.S. Population: Age, Sex, Smoking Status, and Ethnic Differences , 2007, Annals of Internal Medicine.

[8]  S. Rosen,et al.  Prevalence of HIV infection and median CD4 counts among health care workers in South Africa. , 2007, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[9]  D. Burnett.  ISO 15189:2003 – Quality management, evaluation and continual improvement , 2006, Clinical chemistry and laboratory medicine.

[10]  B. Bain,et al.  Dacie and Lewis Practical Haematology , 2006 .

[11]  M. Romano,et al.  Evaluation of the monocyte counting by two automated haematology analysers compared with flow cytometry. , 2005, Clinical and laboratory haematology.

[12]  E. Ulvestad,et al.  Population-Based Hematologic and Immunologic Reference Values for a Healthy Ugandan Population , 2004, Clinical Diagnostic Laboratory Immunology.

[13]  Lesley E Scott,et al.  CD45-assisted PanLeucogating for accurate, cost-effective dual-platform CD4+ T-cell enumeration. , 2002, Cytometry.

[14]  B. Bain.  Ethnic and sex differences in the total and differential white cell count and platelet count. , 1996, Journal of clinical pathology.

[15]  P. Jooste,et al.  The haematological profile of urban black Africans aged 15-64 years in the Cape Peninsula. , 1995, East African medical journal.

[16]  M. Tikly,et al.  Normal haematological reference values in the adult black population of the Witwatersrand. , 1987, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[17]  J. P. Cross,et al.  Haematological reference values for the Basotho. , 1983, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[18]  P. Brain,et al.  Haematological differences in three population groups. , 1979, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.