Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya

Background: Haemoglobinopathies are inherited haemoglobin disorders that result in anaemia characterised by erythrocyte anisopoikilocytosis. Red cell distribution width (RDW) measures anisopoikiloytosis and is readily reported by haematology analysers as a complete blood count parameter. The utility...

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Main Authors: Benard M. Mutua, George Sowayi, Patrick Okoth
Format: Article
Language:English
Published: AOSIS 2022-04-01
Series:African Journal of Laboratory Medicine
Subjects:
Online Access:https://ajlmonline.org/index.php/ajlm/article/view/1644
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author Benard M. Mutua
George Sowayi
Patrick Okoth
author_facet Benard M. Mutua
George Sowayi
Patrick Okoth
author_sort Benard M. Mutua
collection DOAJ
description Background: Haemoglobinopathies are inherited haemoglobin disorders that result in anaemia characterised by erythrocyte anisopoikilocytosis. Red cell distribution width (RDW) measures anisopoikiloytosis and is readily reported by haematology analysers as a complete blood count parameter. The utility of RDW as a diagnostic marker of haemoglobinopathies in Kenya remains undetermined and undocumented. Objective: This study aimed to determine the diagnostic efficacy of RDW in discriminating haemoglobinopathy and haemoglobinopathy-free cases in Kenya. Methods: The case-control study used randomly selected haematology analyser outputs for haemoglobinopathy-free (241, 49.4%) and haemoglobinopathy cases (247, 50.1%) aged 1 month to 66 years old tested in the Aga Khan Hospital, Kisumu, and its satellite centres in western Kenya from 01 January 2015 to 31 December 2020. Results were verified using high performance liquid chromatography. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic power of RDW as a biomarker for sickle cell disease (SCD) and sickle cell trait phenotypes and β-thalassaemia. Results: The RDW showed diagnostic significance in SCD phenotypes at 21.1 ROC curve coordinate with 67.7% sensitivity, 90.0% specificity, 0.789 accuracy, 70.5% positive predictive validity, 88.8% negative predictive validity, 6.77 positive likelihood ratio, 0.36 negative likelihood ratio and 18.94 (11.4–31.4) odds ratio. Conclusion: An RDW of 21.1% is potentially a predictor of SCD haemoglobin phenotypes and should be included in the haematology screening algorithm as a critical value, above which suspected cases qualify to be investigated for SCD.
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spelling doaj.art-18a569427da5493aafc7b3d5fe085c682022-12-22T00:11:53ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102022-04-01111e1e810.4102/ajlm.v11i1.1644360Red cell distribution width as a surrogate marker of haemoglobinopathies in western KenyaBenard M. Mutua0George Sowayi1Patrick Okoth2Department of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, KakamegaDepartment of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, KakamegaDepartment of Biological Sciences, School of Natural and Applied Sciences, Masinde Muliro University of Science and Technology, KakamegaBackground: Haemoglobinopathies are inherited haemoglobin disorders that result in anaemia characterised by erythrocyte anisopoikilocytosis. Red cell distribution width (RDW) measures anisopoikiloytosis and is readily reported by haematology analysers as a complete blood count parameter. The utility of RDW as a diagnostic marker of haemoglobinopathies in Kenya remains undetermined and undocumented. Objective: This study aimed to determine the diagnostic efficacy of RDW in discriminating haemoglobinopathy and haemoglobinopathy-free cases in Kenya. Methods: The case-control study used randomly selected haematology analyser outputs for haemoglobinopathy-free (241, 49.4%) and haemoglobinopathy cases (247, 50.1%) aged 1 month to 66 years old tested in the Aga Khan Hospital, Kisumu, and its satellite centres in western Kenya from 01 January 2015 to 31 December 2020. Results were verified using high performance liquid chromatography. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic power of RDW as a biomarker for sickle cell disease (SCD) and sickle cell trait phenotypes and β-thalassaemia. Results: The RDW showed diagnostic significance in SCD phenotypes at 21.1 ROC curve coordinate with 67.7% sensitivity, 90.0% specificity, 0.789 accuracy, 70.5% positive predictive validity, 88.8% negative predictive validity, 6.77 positive likelihood ratio, 0.36 negative likelihood ratio and 18.94 (11.4–31.4) odds ratio. Conclusion: An RDW of 21.1% is potentially a predictor of SCD haemoglobin phenotypes and should be included in the haematology screening algorithm as a critical value, above which suspected cases qualify to be investigated for SCD.https://ajlmonline.org/index.php/ajlm/article/view/1644red cell distribution widthsurrogate markerbiomarkerhaemoglobinopathiespatientswestern kenya
spellingShingle Benard M. Mutua
George Sowayi
Patrick Okoth
Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
African Journal of Laboratory Medicine
red cell distribution width
surrogate marker
biomarker
haemoglobinopathies
patients
western kenya
title Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
title_full Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
title_fullStr Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
title_full_unstemmed Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
title_short Red cell distribution width as a surrogate marker of haemoglobinopathies in western Kenya
title_sort red cell distribution width as a surrogate marker of haemoglobinopathies in western kenya
topic red cell distribution width
surrogate marker
biomarker
haemoglobinopathies
patients
western kenya
url https://ajlmonline.org/index.php/ajlm/article/view/1644
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