Is manual reticulocyte count a reliable option for under resourced countries?

Area of Science:

• Hematology
• Clinical Pathology

Background:

• Manual reticulocyte counts are essential for diagnosing and monitoring various anemias.
• Automated hematology analyzers offer speed and efficiency but can be costly.

Purpose of the Study:

• To assess the credibility and acceptability of manual reticulocyte counts.
• To compare the accuracy and cost-effectiveness of manual counts against automated analyzers (Coulter STKS and Gen S).

Main Methods:

• Visual reticulocyte enumeration was evaluated for comparability and precision.
• Cost per test was calculated for manual and automated methods.
• Pearson's correlation coefficient was used to analyze results from 80 samples.

Main Results:

• Manual counts showed positive associations with both automated analyzers (r values 0.793-0.884).
• The Coulter STKS analyzer demonstrated higher precision (CV=10.4%) than Gen S (CV=11.6%), with manual counts having the least precision (CV=19.8%).
• Manual counting was significantly more cost-effective ($0.11/test) compared to Gen S ($0.45/test) and STKS ($1.09/test).

Conclusions:

• Manual reticulocyte counting is a reliable tool for estimating reticulocytes.
• It is a cost-effective option suitable for resource-constrained environments.
• Manual counts effectively differentiate high and low reticulocyte ranges for clinical decision-making.