Validation of the international consensus group criteria for slide review following automated complete blood count at Jimma Medical Center, Ethiopia

Abstract

Background: The international consensus group suggested criteria for action following automated complete blood count and white blood cell differential analysis. These criteria were set based on data from laboratories of developed countries. It is highly important to validate the criteria in developing countries where infectious diseases are still rampant that can affect blood cell count and morphology. Thus, this study was aimed to validate the consensus group criteria for slide review at Jimma Medical Center, Ethiopia from February 1 to May 30, 2020. Method: The study comprised a total of 1685 patient samples from the daily laboratory workload of CBC analysis. The samples were collected in K2-EDTA tubes (Becton Dickinson) and analyzed using Coulter DxH 800 and Sysmex XT-1880 hematology analyzers. Slide review was done on two Wright-stained slides for each sample. All statistical analysis were performed using SPSS version 20 software. Result: There were 39.8% positive findings, majority of which were related to red blood cells. The false negative and false positive rates for Sysmex and Coulter analyzer were 2.4% vs. 4.8%; and 4.6% vs. 4.7%, respectively. The false negative rate was unacceptably higher when we used physicians’ triggered slide review, which was 17.3% and 17.9% for Sysmex and Coulter analyzer, respectively. Conclusion: Generally, the consensus group rules are suitable to use in our setting. However, we might still need to modify the rules, particularly to reduce the review rates. It is also necessary to confirm the rules with case mixes proportionally derived from the source population.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research work was funded by Jimma University, Institute of Health research and innovation office (https://research.ju.edu.et/). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical clearance was obtained from Jimma University, Institute of Health Ethical Review Committee. Support letter from Health science research coordinating office was written to JMC. Permission was obtained from medical director office of the medical center.

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Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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