Reference Intervals for CD4 and hemoglobin among apparently healthy pregnant women in Addis Ababa, Ethiopia

Abstract

Background, Most African countries, including Ethiopia, have not developed local well-defined reference intervals for immuno-hematological testes interims of pregnant women, so we were forced to use reference intervals from manufacturer insert kit values derived from non-Africans. This is not appropriate because CD4 cell count tests are affected by ethnic and environmental factors Therefore, this study aimed to develop RI for CD4 cell count and hemoglobin levels for apparently healthy pregnant women in Addis Ababa, Ethiopia. Method From January to June 2019, 162 pregnant women who appeared healthy were enrolled in this community-based cross-sectional study. Social and medical data were gathered through a structured questionnaire following the acquisition of informed consent. BD FACS Presto, a near-patient CD4 counter, was used to obtain the CD4 count and hemoglobin (Hgb) levels from whole blood using a nonparametric test that estimated 2.5th (lower limit) and 97.5th (upper limit) percentiles with 95% CIs. Data were entered and analyzed using SPSS 20 and P < 0.05 was considered statistically significant. Results: After excluding six pregnant women who did not pass the screening tests, 156 apparently healthy pregnant women participants who were 18–49 years old were included in the final analysis. The majority of them were in the 2nd trimester, from the total participants (51.9%) were housewives, and (37.2. %) attained at least primary-level education. The medians of CD4%-and CD4# counts with inter-quartile ranges [IQR] were 757.5 [611.3-925.5] cells/µLand 43.62% [39.9–47.3], respectively while the median and IQR. Hemoglobin values were 14.3gm/dL [13.40–15.10]. The absolute CD4 cell count reference intervals were 416.9-1218.4 cells/µL, %CD4 + 32.1–57.3%, there is no significant difference between the trimester and age difference was observed. Conclusion: Comparing this study's results to those of non-African and African nations, it revealed a decline in both parentage count and absolute CD4 + T cell counts. Therefore, it is essential to establish local reference values for various populations.