Reference ranges for the clinical laboratory derived from a rural population in Kericho, Kenya

• Published in: PloS one 2008-10, Vol.3 (10), p.e3327-e3327
• Main Authors: Kibaya, Rukia S, Bautista, Christian T, Sawe, Frederick K, Shaffer, Douglas N, Sateren, Warren B, Scott, Paul T, Michael, Nelson L, Robb, Merlin L, Birx, Deborah L, de Souza, Mark S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; AIDS Serodiagnosis; AIDS vaccines; Altitude; Anemia; Bilirubin; Biomedical laboratories; Blood; Blood & organ donations; Blood cells; Blood Chemical Analysis; CD4 antigen; Clinical trials; Cohort Studies; Communities; Feasibility studies; Female; Females; Gender aspects; Hematologic Tests; Hematology; Hematology/Anemias; Hemoglobin; Hemoglobins; HIV; Human immunodeficiency virus; Humans; Immunology; Infections; Infectious Diseases/HIV Infection and AIDS; Infectious Diseases/Protozoal Infections; Kenya; Laboratories; Lymphocytes; Lymphocytes T; Malaria; Malaria - diagnosis; Male; Males; Mens health; Middle Aged; Neutropenia; Neutrophils; Pathology/Clinical Chemistry; Public Health and Epidemiology/Screening; Quality Control; Reference Values; Rural areas; Rural Population; Rural populations; Sex differences; Syphilis; Syphilis Serodiagnosis; T cells; Urea; Vaccines; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0003327

The conduct of Phase I/II HIV vaccine trials internationally necessitates the development of region-specific clinical reference ranges for trial enrollment and participant monitoring. A population based cohort of adults in Kericho, Kenya, a potential vaccine trial site, allowed development of clinical laboratory reference ranges. Lymphocyte immunophenotyping was performed on 1293 HIV seronegative study participants. Hematology and clinical chemistry were performed on up to 1541 cohort enrollees. The ratio of males to females was 1.9:1. Means, medians and 95% reference ranges were calculated and compared with those from other nations. The median CD4+ T cell count for the group was 810 cells/microl. There were significant gender differences for both red and white blood cell parameters. Kenyan subjects had lower median hemoglobin concentrations (9.5 g/dL; range 6.7-11.1) and neutrophil counts (1850 cells/microl; range 914-4715) compared to North Americans. Kenyan clinical chemistry reference ranges were comparable to those from the USA, with the exception of the upper limits for bilirubin and blood urea nitrogen, which were 2.3-fold higher and 1.5-fold lower, respectively. This study is the first to assess clinical reference ranges for a highland community in Kenya and highlights the need to define clinical laboratory ranges from the national community not only for clinical research but also care and treatment.