|Year : 2014 | Volume
| Issue : 1 | Page : 33-36
Hematological profile of apparently healthy blood donors at a tertiary hospital in Enugu, south east Nigeria: A pilot study
Thomas Nubila1, Ernest Okem Ukaejiofo1, Nkoyo Imelda Nubila2, Elvis Neba Shu2, Chukwubuzor N Okwuosa3, Mary Bassey Okofu4, Benardine C Obiora1, Irene L Shuneba5
1 Department of Medical Laboratory Sciences, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
2 Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
3 Department of Oromaxillofacial Pathology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
4 Department of Mathematics, Faculty of Physical Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
5 Department of Medicine, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
|Date of Web Publication||1-Jul-2014|
Department of Medical Laboratory Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu
Source of Support: None, Conflict of Interest: None
Background: The transfusion of blood and its components is therapeutic and always associated with some level of risk, which if not well-screened, could lead to several complications. Laboratory tests such as a complete blood count are performed to find out if the patient's symptoms are likely to be relieved. Aim: To evaluate the hematological profile of screened blood donors at a tertiary hospital, Enugu (THE), South East Nigeria. Subject and Methods: Sixty subjects comprising 30 apparently healthy blood donors and 30 non-donors were recruited for the investigation of hematological profile from THE. After obtaining an informed consent, 2 ml venous blood was aseptically collected from the subjects and dispensed into tri-potassium ethylene di-amine tetra-acetic acid anticoagulant bottles and mixed by gentle inversion. Complete blood count was determined by hematology autoanalyzer-Symex-Kx-21N, while thin blood film was prepared for examination of blood cell morphology. Results: The blood picture revealed that 29 donors (96.7%) had normal blood picture while the control recorded 22 (73.3%). There were statistically significant increases in the red blood cell count (P = 0.0115), hemoglobin concentration (P = 0.0047) and packed cell volume (P = 0.0005), total white blood cell (WBC; P = 0.0483), and eosinophil (P = 0.0252) counts in the donors group when compared with the control group. In addition, the erythrocyte sedimentation rate and lymphocyte count recorded a statistically significant decrease (P < 0.001) in the donors when compared with the control group. Conclusion: The result of this present study suggests that the screening procedures for potential blood donors at THE may be regarded as effective in detecting suitable blood donors.
Keywords: Apparently healthy, blood donors, hematological profile
|How to cite this article:|
Nubila T, Ukaejiofo EO, Nubila NI, Shu EN, Okwuosa CN, Okofu MB, Obiora BC, Shuneba IL. Hematological profile of apparently healthy blood donors at a tertiary hospital in Enugu, south east Nigeria: A pilot study. Niger J Exp Clin Biosci 2014;2:33-6
|How to cite this URL:|
Nubila T, Ukaejiofo EO, Nubila NI, Shu EN, Okwuosa CN, Okofu MB, Obiora BC, Shuneba IL. Hematological profile of apparently healthy blood donors at a tertiary hospital in Enugu, south east Nigeria: A pilot study. Niger J Exp Clin Biosci [serial online] 2014 [cited 2022 May 16];2:33-6. Available from: https://www.njecbonline.org/text.asp?2014/2/1/33/135726
| Introduction|| |
The values of hematological parameters are affected by a number of factors even in apparently healthy populations. These factors include age, sex, ethnic background, body build, and social, nutritional, and environmental factors especially altitude. ,,,, It has been demonstrated in several studies that some of the hematological parameters exhibit considerable variations at different periods of life. At birth, the total hemoglobin (Hb) level, red blood cell (RBC) count, and packed cell volume (PCV) are shown to be higher than at any other period of life. , The levels of these parameters then decrease during the next few months after birth, some more steeply than others, with the cells becoming hypochromic due to the development of physiological iron deficiency anemia.  The Hb content and red cells then gradually rise to adult levels by the age of puberty. In general, the female levels are lower than the male levels. ,
Several studies have been carried out in children at various ages and in adolescents, and significant differences have been reported in different populations, seasons, racial and ethnic groups, and gender subgroups. ,,,,,,,,,,,,,, Genetic factors are shown to significantly contribute to all blood cells measurements accounting for between 61-96% of variance. , In almost all studies, the ethnic and gender differences are significant, with Caucasian values being higher than those of Africans and Afro-Caribbean. ,,,,
Blood donations are divided into three types based on the relationship between the donor and the recipient. An allogeneic - also called homologous - donation is when a donor gives blood for storage at a blood bank for transfusion to an unknown recipient. A directed or replacement donation is when a person, often a family member, donates blood for transfusion to a specific individual. Directed donations are rare in developed countries like Canada  but are common in developing countries such as Nigeria and Ghana. The third type is when a person has blood stored that will be transfused back to the person at a later date, usually after surgery. This is called an autologous donation. The World Health Organization gives recommendations for blood donation policies, but in developing countries, many of these are not followed. For example, the recommended testing requires laboratory facilities, trained staff, and specialized reagents, all of which may not be available or too expensive in developing countries.  The goal of blood transfusion services is to provide effective blood and blood products that are as safe as possible, accessible at reasonable costs, and adequate to meet patient's need.
Therefore, this study was aimed at investigating the hematological profile of blood donors at a tertiary hospital, Enugu (THE), South East Nigeria. This will contribute meaningfully to the improvement of the therapeutic use of blood transfusion and its components in particular and blood safety in general.
| Subjects and methods|| |
Study Subjects and Sample Collection
Sixty male adult subjects (30 apparently healthy potential blood donors and 30 age-matched controls) were recruited for the study from THE. Ethical approval was obtained from the ethical committee of the hospital. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. 
After obtaining an informed consent, 2 ml of venous blood was aseptically collected from each subject via the antecubital vein following the standard procedure for venous blood collection. The blood samples were dispensed into tripotassium ethylene diamine tetra-acetic acid (K 3 EDTA) anticoagulant bottles and mixed gently by inversion. Complete blood count (CBC) was determined by both automated (using haematology autoanalyzer-sysmex-kx-2IN) and standard manual methods as described by Dacie and Lewis (1991).  All samples were analyzed within one hour of collection.
Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS), version 14. Student's t-test and one-way analysis of variance was adopted for comparison. Data were expressed as mean ± standard error (SE). P < 0.05 was considered statistically significant.
| Results|| |
[Table 1] shows the blood picture of the subject and control groups studied. The blood picture revealed 29 subjects (96.7%) of the subject group had normal blood picture while the control group recorded 22 subjects (73.3%).
[Table 2] represents the comparison of the red cell and red cell indices values of the subject group with the control group. There was a statistically significant increase (P = 0.0115) in RBC value of the subject group when compared with the control group. Similarly, there was a statistically significant increase (P = 0.0047) in Hb concentration when compared with the control group. Furthermore, erythrocyte sedimentation rate recorded a statistically significant decrease (P < 0.001) in the subject group when compared with the control group. In comparison of the platelet, total WBC, and differential WBC counts of the subject group with the control group, there was a statistically significant increase (P < 0.048) in the total WBC count of the subject group when compared with the control group. However, the lymphocyte count recorded a statistically significant decrease (P < 0.0128) in the subject group when compared with the control group.
|Table 2: Comparison of the mean ± s.e of red cell, platelet, white blood cell, and differential white blood cell count, parameters of donors with control group|
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Furthermore, there was a statistically significant increase (P < 0.0252) in the eosinophil count of the subject group when compared with the control group.
| Discussion|| |
Extensive studies during the last three to four decades conducted in different populations have worked out normal reference ranges for hematological parameters in adults and children ,,,,,,,,,,,,, and have reported significant differences in different ethnic groups. ,,,,, Nutrition and physique also influence hematological parameters. 
From the result of this present study, the blood picture revealed 29 subjects (96.7%) of the subject group had normal blood picture while the control group recorded 22 (73.3%). This indicates that the screening procedures were effective though not completely. Hence, to increase blood safety and enhance blood transfusion, blood film examination could be included as one of the parameters to be investigated among blood donors during screening.
The red blood cell count of the subject group showed a statistically significant increase (P = 0.0115) when compared with the control group. This might be due to poor nutrition in the control group who were mainly age-matched university students and who live mainly on poor diet. In addition, this may also be due to the presence of sub-clinical iron deficiency in the control group as earlier reported by Mohsen et al.
Similarly, there was a statistically significant increase in the hemoglobin concentration (P = 0.0047) and PCV (P = 0.0005) in the subject group when compared with the control group. This might be due to regular intake of some hematinics as reported by Drawdy and Metrone  who reported that hematinics has a stimulatory effect on the hemopoietic organs and erythropoiesis. Furthermore, erythrocyte sedimentation rate recorded a statistically significant decrease (P < 0.001) in the subject group when compared with the control group. This could be attributed to poor nutrition in the control group as earlier suggested and latent infections due to poor environmental sanitation in controls who were mainly university students living in overcrowded hostels.
However, the red cell indices did not differ significantly (P > 0.05) in the subject group when compared with the control group. The most probable explanation might be due to the mild decrease though statistically significant in the red blood cell, Hb concentration, and PCV mean values.
The total white blood cell and eosinophil counts of the subject group demonstrated statistically significant increase (P < 0.05) when compared with the control group. This might be due to some nutritional differences although not investigated or due to variations in age as earlier reported by Mohsen et al. among the different subjects studied. This may likely be as a result of their socioeconomic status/life style. However, there was a statistically significant decrease (P < 0.05) only in the lymphocyte count in the subject group when compared with the control group. This result disagreed with a previous report by Ukaejiofo et al. who recorded a slight higher lymphocyte count in the Nigerian population.
In conclusion, the result of the present pilot study suggests that the screening procedure of potential blood donors at THE is fair though not complete and hence, needs to be standardized. Complete blood count and examination of blood film is hereby recommended as one of the parameters to be assayed on blood donors in order to improve the screening of blood donors and consequently, safe blood transfusion. Also, this study should be conducted on a larger number of screened blood donors and in different transfusion centers.
| References|| |
|1.||Petrova M. Seasonal changes in the makeup of the red blood of healthy children. Probl Khig 1976;2:163-8. |
|2.||Frerichs RR, Webber LS, Srinivasan SR, Berenson GS. Hemoglobin levels in children from a bi-racial southern community. Am J Public Health 1977;67:841-5. |
|3.||Serjeant GR, Grandison Y, Mason K, Serjeant B, Sewell A, Vaidya S. Haematological indices normal negro children: A jamaican cohort from birth to five years. Clin Lab Haematol 1980;2:169-78. |
|4.||Karazawa EH, Jamra M. Normal hematologic parameters. Rev Saude Publica 1989;23:58-66. |
|5.||Evans DM, Frazer IH, Martin NG. Genetic and environmental causes of variation in basal levels of blood cells. Twin Res 1999;2:250-7. |
|6.||Matoth Y, Zaizon R, Varsano L. Postnatal changes in some red cell parameters. Acta Pediatr J Scand 1991;47:261. |
|7.||Burman D. Haemoglobin levels in normal infants aged 3 to 24 months, and the effect of iron. Arc Dis Child 1972;47:261. |
|8.||Dacie JV, Lewis SM. Practical Hematology. 8 th ed. New York: Churchill Livingstone; 2006. p. 22-49. |
|9.||Kelly A, Munan L. Haematological profile of natural populations: Red cell parameters. Bri J Haematol 1997;35:153-60. |
|10.||Taylor MR, Holland CV, Spencer R, Jackson JF, O'Connor GI, O'Donnell JR. Haematological reference range for school children. Clin Lab Haematol 1997;19:1-15. |
|11.||Armstrong P. Full blood counts values in adolescents. Ir Med J 1989;82:68-9. |
|12.||Brain P, Buckle GC, Jamieson M. Haematological differences in three population groups. S Afr Med J 1976;55:635-6. |
|13.||Santiago Borrero PJ. Hemoglobin concentration, hematocrit and red cell index values in metropolitan San Juan children and adolescents. Bol Asoc Med P R 1981;73:538-47. |
|14.||Khraisha S. Comparative Study of haematological values of school children of both sexes at dead sea level and at Amman. Aviat Space Environ Med 1983;54:250-2. |
|15.||Petrova M. Age-related characteristics of hemoglobin and erythrocytes in 7-to 17-year-old pupils. Probl Khig 1984;9:135-9. |
|16.||Castro OI, Haddy TB, Rana SR. Age and sex-related blood cell values in healthy black Americans. Public Health Rep 1987;102:232-7. |
|17.||Saxena S, Wong EI. Heterogeneity of common haematologic parameters among racial, ethnic and gender subgroups. Arch Pathol Lab Med 1990;14:715-9. |
|18.||Daa LN, Hallerud M, Halvorsen SA. Comparison between haematological parameters in capillary and venous blood samples from hospitalized children aged 3 months to 14 year. Scand J Clin Lab Inves 1991;51:651-4. |
|19.||Onwukeme KE, Olomu IN. Haematologic indices in African children. Trop Geogr Med 1991;43:171-3. |
|20.||Bao W, Dalferes ER Jr, Srinivasan SR, Webber LS, Berenson GS. Normative distribution of complete blood count from early childhood through adolescence in the bogalusa heart study. J Prev Med 1993;22:825-7. |
|21.||González Silva M, Bernal MD, Cabezón I. Hematologic values and iron levels in a rural student population]. Sangre (Barc) 1994;39:99-103. |
|22.||Kabata J, Raszeza-Specht A, Steffek I, Angielski S. Reference values for peripheral blood morphology in countryside population of northern Poland. Pol Tyg Lek 1995;50:62-5. |
|23.||Akdag R, Energin VM, Kalayei AG, Karakelleoglv C. Reference limits for routine haematological measurement in 7-14 years old children living in an intermediate attitude (1869 m, Erzurum, Turkey). Scand J Clin Lab Invest 1996;56:103-9. |
|24.||Bain BJ. Ethnic and sex differences in the total and differential white cell count and platelet count. J Clin Pathol 1996;49:664-6. |
|25.||Dal Colletto GM, Fulker DW, Barretto OC, Kolya M. Genetic and environmental effects on blood cells. Acta Genet Med Gemellol (Roma) 1993;42:245-52. |
|26.||Nduka N, Aneka C, Maxwell-Owhochuku S. Comparison of some haematological indices of Africans and Caucasians resident in the same Nigerian environment. Haematologica (Budap) 1988;21:57-63. |
|27.||Wales PW, Lau W, Kim PC. Directed blood donation in pediatric general surgery: Is it worth it? J Pediatr Surg 2001;36:722-5. |
|28.||World Health Organization. World Blood Donor Day 2006 Availbale from: http: //www.who.int/mediacentre/news/releases/2006/pr33/en/index.html [Last accessed on 2006 June 12]. |
|29.||World Medical Association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA 2000;284:3043-5. |
|30.||El-Hazmi MA, Warsy AS. Normal reference values for heamatological parameters, red cell indices, HbA 2 and Hb F from early childhood through adolescence in Saudis. Ann Saudi Med 2001;21:165-9. |
|31.||Dowdy RP, Matrone G. Copper-molybdenum in sheep and chicks. J Nutr 1968;95:191-201. |
|32.||Ukaejiofo EO, Isaacs-Sodeye WA, Seyide Adigun and Ipadeola. Normal Haematological values in Adults Nigerians. Nig Med J 1979;9:118-21. |
[Table 1], [Table 2]
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