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Reference Intervals of Complete Blood Count in Healthy Adult Eritreans

Ahmed O Noury* , Omer A. Musa , Elmuiz Gasmalbari , Barakat M Bakhit1 , Eyasu H Tesfamariam , Danie Abraha , Zekarias B Ghebre6 , Omer Suleman , Efrem G Tesfay , Filmon G Hailezghi

Background: Blood countisthe most commonly prescribed biological examination in general medical practice. The reference intervals of the hematological parameters of this examination are critical for clinical orientations and therapeutic decisions. Because there are racial, ethnic, and geographical differences in complete blood count (CBC) reference intervals (RIs), population-specific RIs must be established. The goals of this study were to identify hematological reference rangesin healthy adult Eritreans. Method: 942 healthy Eritreans between 18 and 60 years old were included, 331 males and 611 females by use of a DXH500 analyzer. The venous blood sample was collected in a tube containing EDTA anticoagulant for the blood tests. SPSS version 25 statistical software was used for data analysis, P value<0.05 was considered significant. A non-parametric test was used for the determination of upper (97.5th percentile) and lower (2.5th percentile) reference interval limits with 95% CI. The Harris and Boyd Rule was used to determine the need for partitioning of reference intervals based on gender. Results: The established 95% reference intervals combined median (2.5th -97.5th percentile) for both males and females were: WBCs: 6.37 (3.02 µL-13.55 µL × 103/µL), Lymph%:39.34 (21.39%-60.54%), Mono%:8.98 (5.18-14.54%), Neut%: 49.13 (16.90%-81.98%), Baso%: 0.22 (0.00%-0.63%), MCV: 87.67 (76.58 fl-97.29 fl), MCH: 27.53 (20.46 pg32.70 pg), MCHC: 31.38 (25.20 g/dl-35.30 g/dl, RDW: 14.65 (12.70%-18.60%), PLT: 286.83 (131.62 µL-453.13 µL × 103/ µL) and MPV: 8.92 (7.28 fl-11.01 fl). The parameters that demand separate RI and their respective median (2.5th -97.5th percentile) for males versus females were: Eosin: 3.86 (0.29%-16.68%) versus 1.80 (0.20%-6.73%), RBCs: 5.57 (4.47-7 µL.69 µL × 106/µL) versus 4.97 (3.98 µL-6.38 µL × 106/µL), Hb: 15.28 (11.48 g/dl-17.99 g/dl) versus 13.50 (10.74 g/ dl-16.54 g/dl), and HCT: 48.75 (38.96%-61.17%) versus 43.19 (34.86%-58.60%). The median of WBCs wassignificantly higher in females than males, the mean WBCs were lower in people residing at high altitudes compared to those leaving at low altitudes, and the WBC is significantly higher among obese participants. The median Platelet count is significantly higher in femalesthan in males. Conclusion: The reference intervals established in this study differ from the international one and thus should be used for the interpretation of laboratory resultsin diagnosis and follow-up in Eritrea. The study showed significant variations in Hb levels, RBCs count, WBCs count, and platelet according to gender, Age, BMI, and physical activity.

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