title: A pilot study to determine the normal haematological indices for young Malawian adults in Blantyre, Malawi.
abstract: BACKGROUND
  Reference ranges for haematological and other laboratory tests in most African countries are based on populations in Europe and America and, because of environmental and genetic factors, these may not accurately reflect the normal reference ranges in African populations.
  
  
  OBJECTIVE
  To determine the distribution of haematological parameters in healthy individuals residing in Blantyre, Malawi. We also examined the effect of sociodemographic and nutritional factors on the haematological variables.
  
  
  METHODS
  We conducted a proof-of-concept cross-sectional study, involving 105 healthy blood donors at Malawi Blood Transfusion Service in Blantyre. Eligible participants were HIV-negative males and females, aged 19 to 35 years, who did not have any evidence of acute or chronic illness, or blood-borne infection. We performed the haematological tests at the Malawi-Liverpool Wellcome Trust laboratory in Blantyre, and the screening tests at Malawi Blood Transfusion Service laboratories.
  
  
  RESULTS
  Out of 170 consenting healthy volunteers, haematological results were available for 105 participants. The proportions of results which were below the lower limit of the manufacturer's reference ranges were 35.2% (37/105) for haemoglobin, 15.2% (16/105) for neutrophils, 23.8% (25/105) for eosinophils, and 88.6 % (93/105) for basophils. The proportions of results that were above the upper limit of the manufacturer's reference ranges were 9.5% (10/105) for platelets and 12.4% (13/105) for monocytes. We also observed that the mean leucocyte and basophil counts were significantly higher in males than females (p = 0.042 and p = 0.015, respectively). There were no statistically significant differences in haematological results observed among different ethnic, age, and body mass index groups.
  
  
  CONCLUSIONS
  Over half of otherwise healthy study participants had at least one abnormal haematological result, using previously established foreign standards. More detailed studies are needed to establish locally relevant normal ranges for different age groups and other demographic characteristics of the Malawian population. This will lead to accurate interpretation of laboratory results.
authors.affiliation: Laboratory Section, Mzuzu Central Hospital, Mzuzu, Malawi.
authors.forename: M R
authors.initials: MR
authors.lastname: Chisale
authors.affiliation: Department of Biomedical Sciences, Mzuzu University, Mzuzu, Malawi.
authors.forename: P
authors.initials: P
authors.lastname: Kumwenda
authors.affiliation: Department of Biomedical Sciences, Mzuzu University, Mzuzu, Malawi.
authors.forename: M
authors.initials: M
authors.lastname: Ngwira
authors.affiliation: Malawi Blood Transfusion Service, Blantyre, Malawi.
authors.forename: B
authors.initials: B
authors.lastname: M'baya
authors.affiliation: Department of Pathology and Laboratory Sciences, College of Medicine, University of Malawi, Blantyre Malawi.
authors.forename: B I
authors.initials: BI
authors.lastname: Chosamata
authors.affiliation: Department of Public Health, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: V
authors.initials: V
authors.lastname: Mwapasa
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis / Q000592:standards*; D001782:Blood Donors; D003430:Cross-Sectional Studies; D005260:Female; D006403:Hematologic Tests / Q000592:standards*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008295:Malawi; D008297:Male; D010865:Pilot Projects; D012016:Reference Values; D055815:Young Adult
chemical_list: D006454:Hemoglobins