Reference Intervals for Hematology Test Parameters from Apparently Healthy Individuals in Southwest Ethiopia

Background: Clinical laboratory reference intervals are an important tool to identify abnormal laboratory test results. The generating of hematological parameters reference intervals for local population is very crucial to improve quality of health care, which otherwise may lead to unnecessary expenditure or denying care for the needy. There are no well-established reference intervals for hematological parameters in southwest Ethiopia.

Objective: To generate hematological parameters reference intervals for apparently healthy individuals in southwest Ethiopia.

Methods: A community-based cross-sectional study was conducted involving 883 individuals from March to May 2017. Four milliliter of blood sample was collected and transported to Jimma University Medical Center Laboratory for hematological analysis and screening tests. A hematological parameters were measured by Sysmex XS-500i hematology analyzer (Sysmex Corporation Kobe, Japan). The data were analyzed by SPSS version 20 statistical software. The non-parametric independent Kruskal-Wallis test and Wilcoxon rank-sum test (Mann-Whitney U test) were used to compare the parameters between age groups and genders. The 97.5 percentile and 2.5 percentile were the upper and lower reference limit for the population.

Results: The reference interval of red blood cell, white blood cell, and platelet count in children were 4.99 × 10/L (4.26-5.99 × 10/L), 7.04 × 10/L (4.00-11.67 × 10/L), and 324.00 × 10/L (188.00-463.50 × 10/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in adults was 5.19 × 10/L (4.08-6.33 × 10/L), 6.35 × 10/L (3.28-11.22 × 10/L), and 282.00 × 10/L (172.50-415.25 × 10/L), respectively. The reference interval of red blood cell, white blood cell, and platelet count in geriatrics were 5.02 × 10/L (4.21-5.87 × 10/L), 6.21 × 10/L (3.33-10.03 × 10/L), and 265.50 × 10/L (165.53-418.80 × 10/L), respectively. Most of the hematological parameters showed significant differences across all age groups.

Conclusion: Most of the hematological parameters in this study showed differences from similar studies done in the country. This study provided population-specific hematological reference interval for southwest Ethiopians. Reference intervals should also be established in the other regions of the country.