Mugisha Joseph O, Seeley Janet, Kuper Hannah
MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda.
London School of Hygiene and Tropical Medicine, London, UK.
BMC Res Notes. 2016 Sep 7;9(1):433. doi: 10.1186/s13104-016-2217-x.
Haematology reference values are needed to interpret haematology results and make clinical decisions, but these have not been established for old people in sub-Saharan Africa. The objective of this study was to establish haematology reference values for people aged 50 years and above in Uganda, to compare the haematology reference values for those aged 65 years and over with those less than 65 years and to compare these haematology reference values with established haematology reference values for old people from high income countries.
A total of 1449 people aged 50 years and above were recruited from the Medical Research Council/Uganda Virus Research Institute general population cohort between January 2012 and January 2013 (response rate 72.3 %). From the blood samples collected, we did haematology, HIV testing and malaria tests. We also obtained stool samples and tested them for hookworm infection. Questionnaire data were obtained through interviews. In the analysis, we excluded those with HIV infection, malaria infection, hookworm infection and those not feeling well at the time of recruitment. Medians and reference ranges for 12 haematology parameters were determined, based on the Clinical Laboratory and Standards institute's guidelines.
In total, 903 people aged 50 years and above were included in the analysis with the majority 545 (60.3 %) being female. Men had significant difference in median haemoglobin, haematocrit, erythrocytes counts and white blood cells counts, which were higher than those of women. Women had significant difference in mean platelet counts and neutrophil percentages which were higher than those of men. Comparing those aged 65+ and those aged less than 65 years, the following parameters were significantly lower in those aged above 65 years: haemoglobin, haematocrit, erythrocytes counts, platelets and mean corpuscular volume. Compared to the reference intervals from old people in high income countries, all the haematology parameters from our study population were low.
The differences between haematology reference ranges in old people compared to adults and the very old (65+) compared to those between 50 and 65 call for more population based studies using nationwide surveys to be carried out among old people in other study settings in Uganda and the rest of Africa to explore the differences in haematology reference ranges between these different age groups with a view of establishing whether there is need to have separate reference range for these different categories of old people.
解读血液学检查结果并做出临床决策需要血液学参考值，但撒哈拉以南非洲地区的老年人尚未建立此类参考值。本研究的目的是确定乌干达50岁及以上人群的血液学参考值，比较65岁及以上人群与65岁以下人群的血液学参考值，并将这些血液学参考值与高收入国家老年人已建立的血液学参考值进行比较。
2012年1月至2013年1月期间，从医学研究理事会/乌干达病毒研究所普通人群队列中招募了1449名50岁及以上的人（应答率72.3%）。从采集的血样中，我们进行了血液学、HIV检测和疟疾检测。我们还获取了粪便样本并检测钩虫感染情况。通过访谈获取问卷数据。在分析中，我们排除了那些感染HIV、疟疾、钩虫以及招募时感觉不适的人。根据临床实验室和标准协会的指南，确定了12项血液学参数的中位数和参考范围。
共有903名50岁及以上的人纳入分析，其中大多数为545名女性（60.3%）。男性的血红蛋白、血细胞比容、红细胞计数和白细胞计数中位数存在显著差异，均高于女性。女性的平均血小板计数和中性粒细胞百分比存在显著差异，均高于男性。比较65岁及以上人群和65岁以下人群，65岁以上人群的以下参数显著较低：血红蛋白、血细胞比容、红细胞计数、血小板和平均红细胞体积。与高收入国家老年人的参考区间相比，我们研究人群的所有血液学参数都较低。
老年人与成年人之间以及高龄（65岁以上）与50至65岁人群之间血液学参考范围的差异，要求在乌干达和非洲其他地区的其他研究环境中，针对老年人开展更多基于全国性调查的人群研究，以探索这些不同年龄组之间血液学参考范围的差异，从而确定是否需要为这些不同类别的老年人制定单独的参考范围。
