Vol.5, No.8, 1261-1267 (2013) Health
doi:10.4236/health.2013.58171
Hematology and blood serum chemistry reference
intervals for children in Iganga district of Uganda
Fred Kironde
1,2*
, Musa Sekikubo
1
, Halima Naiwumbwe
1
, Fatuma Namusoke
1
,
William Buwembo
1
, Steven Kiwuwa
1
, Brenda Oketch
3
, Ramadhani Noor
3
,
Roma Chilengi
4
, Edison Mworozi
1
, Mark Kaddumukasa
1
1
Makerere University College of Health Sciences, Kampala, Uganda;
*
Corresponding Author: faskironde@gmail.com
2
Makerere University College of Natural Sciences, Kampala, Uganda
3
African Malaria Network Trust, Dar-es Salaam, Tanzania
4
Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
Received 11 June 2013; revised 12 July 2013; accepted 31 July 2013
Copyright © 2013 Fred Kironde et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
In this study, normal ranges for hematology and
serum biochemistry in children aged 1 to 5 years
in Uganda were determined. By a cross-sec-
tional study, 1168 children from Iganga, a pro-
spective site for clinical trials in Uganda, were
screened. From 1168 households, 460 children
were selected for enrollment, while 600 (58%)
were excluded because of either a history of
fever in the previous 24 hours, presence of asex-
ual malaria parasites in the peripheral blood or
presence of fever. Accordingly, 460 children
(39.4%) of median age = 3 years were enrolled in
the baseline study. While the lower limits of
hemoglobin, hematocrit levels, mean corpuscu-
lar volume and platelet counts for the Ugandan
children were found to be less than conventional
reference values of Caucasisan children, the
white blood cell count reference values were
higher than the international intervals. On the
other hand, the upper limits of the reference in-
tervals for serum transaminases, bilirubin, cre-
atinine, urea, total protein and albumin in sera of
the Ugandan children were higher than the cor-
responding values for a Caucasian pediatric
population. This study showed that, if hematol-
ogy test results of the Ugandan children were
assessed against “imported” international refer-
ence values, up to 44.6% of the study partici-
pants would have been excluded from clinical
trials or would have been reported as adverse
events in such trials. The present study was not
only the first report of serum biochemistry ref-
erence ranges for children aged one to five
years in Uganda but also one of very few such
studies in Africa.
Keywords: Normal; Intervals; Reference; Uganda;
Children; Hematology; Serum; Biochemistry; Iganga
1. INTRODUCTION
Complete blood count (CBC) [1] and serum biochem-
istry test [2,3] are commonly used not only to assess
overall health but also to diagnose and monitor disease as
well as determine the effect and safety of interventions
including treatment and vaccines. Increasingly, many cli-
nical trials in Africa involve children and pregnant wo-
men [4-6]. However, although considerable efforts have
been expended into developing capacity in the conduct
of clinical trials in many sites across Africa towards im-
proved intervention against diseases [7,8], information
on the normal hematologic and serum biochemical fea-
tures of African children is scanty. By and large, the
normal ranges of blood cell counts and serum biochemi-
cal constituents currently used in Africa are derived from
data collected from populations living in industrialized
countries of North America and Europe. Many of these
imported hematology and blood biochemistry values are
available in textbooks or in the guidelines provided by
manufacturers of laboratory test kits and equipment. Yet,
such reference intervals for European populations are not
identical to the normal values for populations in the dis-
ease endemic trial sites [9]. For example, adult Africans
have been reported to have lower levels of hemoglobin,
red blood cells, platelets, neutrophils, eosinophils and
monocyte counts compared with populations in the Wes-
tern countries [10-13]. Similarly, hematology and im-
munology tests of Eastern and Southern African adult
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