# 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.

## Key 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).