Establishment of haematological and immunological reference values for healthy Tanzanian children in Kilimanjaro Region.
OBJECTIVE
To determine the normal haematological and immunological reference intervals for healthy Tanzanian children.


METHODS
We analysed data from 655 HIV-seronegative, healthy children from 1 month to 18 years of age from the Kilimanjaro Region of Tanzania for this cross-sectional study. Median and 95% reference ranges were determined for haematological and immunological parameters and analysed by age cohorts, and by gender for adolescents.


RESULTS
Median haemoglobin (Hb) and haematocrit (Hct) for all age groups were higher than established East African reference intervals. Compared to U.S. intervals, reference ranges encompassed lower values for Hb, Hct, mean corpuscular volume, and platelets. Applying the U.S. National Institute of Health Division of AIDS (DAIDS) adverse event grading criteria commonly used in clinical trials to the reference range participants, 128 (21%) of 619 children would be classified as having an adverse event related to Hb level. CD4-positive T-lymphocyte absolute counts declined significantly with increasing age (P < 0.0001). For those aged under five years, CD4-positive T-lymphocyte percentages are lower than established developed country medians.


CONCLUSIONS
Country-specific reference ranges are needed for defining normal laboratory parameters among children in Africa. Knowledge of appropriate reference intervals is critical not only for providing optimal clinical care, but also for enrolling children in medical research. Knowledge of normal CD4-positive T-lymphocyte parameters in this population is especially important for guiding the practice of HIV medicine in Tanzania.
Buchanan
Ann M
AM
Division of Pediatric Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA. ann.buchanan@duke.edu
Muro
Florida J
FJ
Gratz
Jean
J
Crump
John A
JA
Musyoka
Augustine M
AM
Sichangi
Moses W
MW
Morrissey
Anne B
AB
M'rimberia
Jane K
JK
Njau
Boniface N
BN
Msuya
Levina J
LJ
Bartlett
John A
JA
Cunningham
Coleen K
CK
D000293:Adolescent; D001774:Blood Chemical Analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006400:Hematocrit; D006403:Hematologic Tests / Q000592:standards*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007159:Immunologic Tests / Q000592:standards*; D007223:Infant; D008297:Male; D012016:Reference Values; D013636:Tanzania
D006454:Hemoglobins