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Distribution of haematological and chemical pathology values among infants in Malawi and Uganda
Newton I Kumwenda1, Tiwonge Khonje, Linda Mipando
1Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Insights
Reference laboratory values for infants in sub-Saharan Africa are scarce. This study establishes haematological and chemical pathology reference ranges for healthy infants in Malawi and Uganda, crucial for clinical practice.
Area of Science:
- Paediatric Haematology
- Clinical Chemistry
- Public Health in Africa
Background:
- Limited paediatric reference laboratory values exist for sub-Saharan Africa.
- Establishing local reference ranges is vital for accurate diagnosis and monitoring.
- This study addresses this gap for infants in Malawi and Uganda.
Purpose of the Study:
- To describe the distribution of haematological and chemical pathology values in healthy infants.
- To establish reference ranges for infants aged 0-6 months in Malawi and Uganda.
- To compare these values between the two study sites.
Main Methods:
- Cross-sectional study of 541 healthy infants (0-6 months) from Malawi and Uganda.
- Blood samples analyzed for haematology and chemical pathology parameters using standard methods.
- Descriptive analyses performed by age-group, comparing means and interquartile ranges by site.
Main Results:
- Mean laboratory values were comparable between Malawi and Uganda.
- Age-related variations observed: lower alkaline phosphatase in neonates, higher AST, creatinine, bilirubin, GGT in the first week.
- Haematocrit, haemoglobin, and neutrophil counts were higher in younger infants (<35 days) and lower than US norms; RBC/WBC counts varied with age; basophil counts higher in Malawi, eosinophils/platelets higher in Uganda.
Conclusions:
- Chemical pathology and haematological values in healthy infants from Malawi and Uganda are comparable.
- These findings provide valuable reference values for clinical use in these regions.
- The data supports the establishment of region-specific paediatric laboratory norms.
Background:
Data on paediatric reference laboratory values are limited for sub-Saharan Africa.
Objective:
To describe the distribution of haematological and chemical pathology values among healthy infants from Malawi and Uganda.
Methods:
A cross-sectional study was conducted among healthy infants, 0-6 months old, born to HIV-uninfected mothers recruited from two settings in Blantyre, Malawi and Kampala, Uganda. Chemical pathology and haematology parameters were determined using standard methods on blood samples. Descriptive analyses by age-group were performed based on 2004 Division of AIDS Toxicity Table age categories. Mean values and interquartile ranges were compared by site and age-group.
Results:
A total of 541 infants were included altogether, 294 from Malawi and 247 from Uganda. Overall, the mean laboratory values were comparable between the two sites. Mean alkaline phosphatase levels were lower among infants aged ≤21 days while aspartate aminotransferase, creatinine, total bilirubin and gamma-glutamyl transferase were higher in those aged 0-7 days than in older infants. Mean haematocrit, haemoglobin and neutrophil counts were higher in the younger age-groups (<35 days) and overall were lower than US norms. Red and white blood cell counts tended to decrease after birth but increased after ∼2 months of age. Mean basophil counts were higher in Malawi than in Uganda in infants aged 0-1 and 2-7 days; mean counts for eosinophils (for age groups 8-21 or older) and platelets (for all age groups) were higher in Ugandan than in Malawian infants. Absolute lymphocyte counts increased with infant age.
Conclusion:
The chemical pathology and haematological values in healthy infants born to HIV-uninfected mothers were comparable in Malawi and Uganda and can serve as useful reference values in these settings.
