Full blood count and white cell differential count reference ranges obtained from a healthy urban South African population residing in the Western Cape of South Africa

Abstract

Background Research has suggested that individuals of African descent have lower white cell and neutrophil counts than Caucasians. These differences could lead to incorrect clinical decisions, and therefore, ethnic‐specific reference ranges are required. The Western Cape region of South Africa is uniquely diverse, comprising Caucasian, Mixed Ancestry and those of African descent. The aim of this study was to compare the full blood count and differential counts across the three major ethnic groups residing in this area and to propose appropriate RIs. Methods The study formed part of the international project led by the Committee on Reference Intervals and Decision Limits (C‐RIDL), and therefore, the strict guidelines laid out by the committee were followed. Full blood count and differential counts were performed on a Beckman Coulter ACT 5 diff AL analyser within 2‐4 hours of collection and were reported as mean (standard deviation), 2.5th and 97.5th percentiles. Comparisons were analysed using Spss v25 and Statistica v13, and a P value of < 0.05 was considered significant. Results Reference ranges for Caucasian and Mixed Ancestry individuals were similar while white cell (P = 0.016), monocyte (P < 0.001), neutrophil (P = 0.034) and red cell indices were significantly different amongst the three population groups. There were however no statistical and clinical significant differences between the eosinophil, lymphocyte, red cell and platelet counts across the three groups. Conclusion In conclusion, subjects of Mixed Ancestry, in this region, have similar reference intervals to those of European descent, while lower white cell and neutrophil counts in Africans have been confirmed.

Continuous changes in biological levels of complete blood count in a high altitude area of China

“…A large WBC count contributes to the body's resistance to inflammation, but in acute inflammation, excessive WBCs may participate in the inflammatory response and cause harm to the body. Compared with results reported in the literature, 7 overall levels of WBC, NEUT, LYMPH, MONO, RBC, HGB, HCT and RDW were higher than in Africans or Caucasians, but the overall number of PLT was lower than in Africans or Caucasians. It is unclear whether these differences are attributable to ethnicity or geographical location.…”

Establishing hematological reference intervals in healthy adults: Ravansar non‐communicable disease cohort study, Iran

“…Ethnic differences in the RIs of hematological parameters have been indicated in some populations such as Asians/Americans and American blacks compared to whites 5 and South Indians compared to European populations 6 . Also, differences in hematological reference values between African and Western populations have been reported 19,20 . Further, comparing the present study with the study of Rasouli et al 15 among blood donors from Tehran Blood Transfusion Center demonstrated different hematological reference values in both Iranian populations.…”

Reference intervals of white blood cell parameters for healthy adults in japan

“…Previous reports from Korea, 21 China, 16,20,27 Thailand, 17 Hawaii, 19 and the Netherlands 24 have also shown that women have lower proportions and counts of monocytes and eosinophils in comparison to men. However, reports from Malaysia 28 and South Africa 29 did not show such sex differences. Thus, ethnicity, geography, and cultural background might affect the sex differences in monocytes and eosinophils.…”