Lack of consensus in inter-laboratory haematology results in selected laboratories in the southern and northern zones of Ghana

TL;DR

This study found significant differences in blood test results between labs in northern and southern Ghana, highlighting the need for better quality control.

Contribution

The study reveals inconsistencies in hematology results across Ghanaian labs, emphasizing the need for a national quality assessment scheme.

Findings

Significant differences in hemoglobin levels were found between northern and southern zone laboratories.

Total white blood cell and platelet counts varied significantly across participating labs.

Intra-laboratory results showed non-reproducibility with %CV values exceeding acceptable limits.

Abstract

To assess the inter-laboratory comparability and intra-assay reproducibility of full blood count (FBC) results.

Exploratory cross-sectional study.

Three and two selected medical laboratories in the northern and southern zones, respectively.

Forty-nine individuals per zone; 16 type 2 diabetes mellitus, 16 with HbAS haemoglobin type and 17 normal samples

Each sample was run eleven times through the analysers in the participating laboratories to evaluate intra-laboratory reproducibility and comparability of FBC results.

Intra-laboratory reproducibility was evaluated using %coefficient variation (%CV). Interlaboratory comparisons were assessed through t-test or One-Way ANOVA for two-sample and three-sample tests. All statistical testing was undertaken using the two-tailed assumption.

Statistically significantly different haemoglobin levels were estimated in both northern and southern zones (mean difference 0.00 g/dL to 3.75 g/dL vs 0.18 g/dL to 1.92 g/dL respectively). Also, total WBC counts significantly differed across laboratories in both northern and southern zones (mean difference 0.15 ×109/L - 3.86 ×109/L vs 0.02 ×109/L to 1.39 ×109/L respectively). Furthermore, platelet counts significantly differed across the participating laboratories in the northern and southern zones (mean difference 0.40 ×109/L to 299.76 ×109/L vs 5.7 ×109/L to 76.9 ×109/L respectively). Moreover, there was evidence of non-reproducibility of results within the respective laboratories in each zone as the respective %CV were outside the acceptable limits.

The intra-laboratory non-reproducibility and inter-laboratory non-comparability of FBC results highlight the need to establish a national quality assessment scheme to harmonise laboratory practices nationwide.

This study was funded by the University of Cape Coast Individual-Led Research Support Grant (RSG-INDI-CoHAS-2019-107).