Open Access Original Research Article

Comparative Malaria Diagnosis Using LH750 Beckman Coulter Automated Analyser in India: A Cross Sectional Case Control Study

B. Mathews, C. Manohar, A. Kamat, V. Neeravari

Asian Hematology Research Journal, Page 1-8

Objective: To study the VCS pattern in patients with malaria and compare it with patients having fever who were negative for malarial parasite (P. falciparum, vivax, malariae and ovale) and normal individuals and to determine whether a further adaptation of the discriminant factor is needed using additional parameters from the VCS data analysis using Beckmann Coulter LH 750.

Design: Cross sectional Case control study.

Setting: Clinical Laboratory and Haematology Department, KMC, India.

Patients: Ninety-three Malaria positive samples and fifty malaria negative samples by QBC method comprised the Case and hundred healthy adult samples formed the Control group.

Interventions: All blood samples were analysed using LH750 Beckman Coulter for VCS data of the neutrophils, lymphocytes, monocytes and eosinophils and compared between Malaria positive, Malaria negative and Control Group.

Main Outcome Measure: Discriminant Factor.

Results: The difference in SD volume of the lymphocyte and monocyte among malaria positive and negative were statistically significant. By using logistic regression, the “Malaria factor” is defined. ROC analysis showed using a cut-off value of 2.7 as malaria factor derived from SD volume, specificity of 92.5 and sensitivity of 83.7 with a PPV of 88.6% and NPV of 89.1% were obtained whereas, specificity and sensitivity obtained using SD conductivity (91 and 75.5 respectively) and SD scatter (68.7 and 57.1 respectively) were significantly less.

Conclusions: A “suspect malaria” flag could be generated on the analyser, allowing the detection of cases of unsuspected malaria and therefore, early diagnosis of the disease with the potential of reducing the possibility of serious complications however this is not a confirmative test.

Open Access Original Research Article

Correlating Automated IRIA ESR Analyzer and Westergreen Method for Determination of Erythrocyte Sedimentation Rate

Jean Baptiste Niyibizi, Roger Kusinga Miruho, Peris Onyambu

Asian Hematology Research Journal, Page 1-6

The erythrocyte sedimentation rate (ESR), or sedimentation rate (sed rate), is a measure of the settling of red blood cells in a tube of blood during one hour. The rate is an indication of inflammation and increases in many diseases. Westergreen method is routinely used determination of ESR, however, it requires large volume of blood and it is time consuming as it takes one hour for analysis. In order to overcome these challenges, new technologies have implemented an automated system which saves on labour, no need for aliquots, shorter turnaround time and minimizes exposures of laboratory staff to biohazard risks. The main objective of this study was to compare Westergreen method and automated IRIA analyzer in determination of ESR. The specific objectives were to determine the ESR using both Westergreen tube method and automated IRIA analyzer and to determine the correlation between Westergreen tube method and automated IRIA analyzer methods. This cross-sectional study was carried out in 205 blood samples at Polyclinique La Medicale from August 2017 to April 2018. Data were analyzed using SPSS, version 21. The current study included a total of 205 participants 123 (60%) females and 82 (40%) males. For a total of 205 participants, the normal tests on westergren method were 142 (69.3%) and abnormal tests were 63 (30.7%), whereas for automated IRIA ESR analyzer, 131 (63.9%) were normal and 74 (36.1%) tested abnormal. There was a strong correlation between automated IRIA ESR analyzer and Westergreen method with r=0.9. The authors recommend that IRIA ESR analyzer should be used in determining ESR due to its advantages over Westergreen method.

Open Access Original Research Article

Reference Intervals of Prothrombin Time and Activated Partial Thromboplastin Time and Their Association with Age among Healthy Adults in Kumasi, Ghana

David Ntiamoah Ofosu, Otchere Addai-Mensah, Lillian Antwi-Boateng, Kwabena Anane, Eddie-Williams Owiredu

Asian Hematology Research Journal, Page 1-8

Prothrombin time (PT) and activated partial thromboplastin time (APTT) are used to assess blood coagulation disorders. Use of reference intervals from a different population may result in misinterpretation and misdiagnoses as the reference intervals for the two tests vary from one geographical area to the other. This study established reference intervals for PT and APTT and evaluated their association with age among healthy adults in Kumasi, Ghana. A total of 876 healthy adults, 18-48 years, all residents of Kumasi, Ashanti region, Ghana were recruited for this cross-sectional study conducted at Komfo Anokye Teaching Hospital (KATH). PT and APTT were determined using the Biobase COA series Semi Auto Coagulation Analyzer following the manufacturer’s instructions. Reference intervals were established using non-parametric approach: 2.5th-97.5th percentiles. The reference intervals for PT and APTT were 11.4-15.9 seconds and 26.3-44.1 seconds respectively. The reference intervals were wider compared to the reference intervals used at KATH. Participants between the ages of 21-30 years old had significantly higher PT and APTT compared with participants between 18-20 years and 31-48 years old. PT was inversely associated with age (β = -1.092, p=.000) among the general population. Upon grouping subjects by gender, PT showed a significant inverse association (β = - .705, p=.000) among males and a direct association (β = .566, p=.004) among females. The association between age and APTT was not statistically significant. There are wider reference intervals for PT and APTT among people in Kumasi. Due to geography, lifestyle, and genetic diversity, it is advisable that each laboratory establishes geography-specific reference intervals for PT and APTT.

Open Access Original Research Article

Some Haematological Parameters, Malondialdehyde and Glutathione Peroxidase Status of Diabetic Patients in Sokoto, Nigeria

Onuigwe Festus Uchechukwu, Abubakar Auwal Nasir, Erhabor Osaro, Buhari Hauwa Ali, Marafa Hamidu Ahmed, Bagudo Aliyu Ibrahim, Uchechukwu Nkechi Judith, Amilo Grace Ifechukwudebelu, Ibeh Nancy Chitogu

Asian Hematology Research Journal, Page 1-13

Background: World Health Organization statistics identify 150 million people with diabetes mellitus worldwide and suggest that this figure may double by 2025.

Aim: This research was conducted to determine the status of some haematological parameters and free radicals among diabetic patients attending Specialist Hospital, Sokoto.

Study Design: This was a case control study involving two groups; 29 controls (non-diabetic) and 58 diabetic subjects.

Methodology: The participants were divided into two groups; 29 controls (non-diabetic) and 58 diabetic subjects. Five milliliters (5 ml) of blood was collected into ethylenediaminetetraacetic acid (EDTA) and plain containers for haematological and free radicals’ analysis respectively. The full blood count (FBC) investigation was carried out using automated haematology analyser while malondialdehyde (MDA) and glutathione peroxidase status (GPx) investigations were carried out using chemical and enzymatic methods respectively. The FBC, GPx and MDA status of both control and subjects were compared in this study.

Duration: The study lasted for a period of six months between April to September, 2017.

Results: The results obtained in this study showed a significant increase in WBC, neutrophil, eosinophil and Platelet counts of diabetic subjects (P ≤ 0.05) when compared with controls, while other FBC parameters, MDA and GPx were not significant (P> 0.05). There was significant decrease in the basophil count of the diabetic subjects based on marital status (P ≤0.04), while other parameters measured were not significant (P> 0.05). The result also showed a significant increase in the MDA of diabetic subjects based on age (P≤ 0.05), while others were not significant (p>0.05). the study also showed no statistical difference in the FBC, MDA and GPx of the smokers and non-smokers (P˃0.05)

Conclusion: This research shows that WBC count, neutrophil, eosinophil and platelet count of the diabetic patients increased.  There is need for a further research on direct free radical estimation and total antioxidant status in relation to diabetes, which gives more information than the indirect method of estimation. It is recommended that white blood cells and platelet levels should be closely monitored for proper management diabetic patients.

Open Access Original Research Article

Evaluation of the Diagnostic Value of Ret-He among Sickle Cell Disease Children with Iron Deficiency Anaemia on Haematinics

David Ntiamoah Ofosu, Clement Opoku-Okrah, Victoria Bam, Selorm Philip Segbefia

Asian Hematology Research Journal, Page 1-7

Introduction: The determination of the amount of hemoglobin in reticulocytes provides a more real-time assessment of the iron status of the bone marrow. Ret-He, the iron molecule found in reticulocytes, unlike most biochemical markers is not affected by inflammation. Hence its determination provides a better way of detecting the presence or absence of iron for erythropoiesis.

Objectives: The aim of the study was to evaluate the diagnostic value of Ret-He and to compare it with serum ferritin and Red Blood Cell (RBC) indices: haemoglobin (Hb), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH) and Red Cell Distribution Width (RDW) in detecting iron deficiency among Sickle Cell Disease (SCD) children.

Materials and Methods: 89 SCD children attending KATH sickle cell clinic were enrolled in the study. Complete Blood Count (CBC), Reticulocyte haemoglobin content (Ret-He) and biochemical tests [ferritin and C - reactive protein (CRP)] were performed from venous blood samples. Iron deficiency anaemia (IDA) was diagnosed when subject’s Hb, MCV, MCH, RDW, serum ferritin and Ret-He were below cut-off values.

Results: Receiver Operating Characteristic (ROC) analysis showed the following results: RBC indices (AUC=0.953, sensitivity=90.7%, specificity=100%, p <0.05), Ret-He (AUC=0.647, sensitivity=34.9%, specificity=94.4%, p > 0.05) and serum ferritin (AUC=0.476, sensitivity=90.2%, specificity=11.1%, p > 0.05). 

Conclusion: The findings of this study suggest that the red cell indices is the most accurate, sensitive and specific among the three diagnostics tools used in this study to detect IDA in SCD children on hematinics.