Hematological Reference Intervals in Diverse Populations
Summary
Hematological reference intervals play a pivotal role in clinical decision-making, defining the expected ranges for blood cell counts and related measures in healthy individuals. Historically, intervals derived from European or North American cohorts have been widely adopted, yet mounting evidence reveals substantial variation according to genetics, geography, age, sex and environmental exposures. Differences in red blood cell counts, haemoglobin concentration and leukocyte subsets, for instance, have been documented across sub-Saharan Africa, South Asia and Latin America. Accurately tailored intervals improve diagnostic precision, reduce misclassification of patients and ensure equitable enrolment in clinical trials. Recent efforts have emphasised rigorous statistical approaches, uniform exclusion criteria and the establishment of region-specific, sex- and age-stratified ranges. Beyond their clinical utility, these data inform public health strategies by revealing population-level susceptibilities to anaemia, infection or inflammatory conditions. As the global population becomes ever more diverse, standardising methodologies and integrating demographic, lifestyle and genetic data will be essential to produce reference intervals that are both universally comparable and locally relevant.
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Hematological Reference Intervals in Diverse Populations publication trend
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Technical terms
Hematological reference interval: The 95 per cent range (typically the 2.5th to 97.5th percentiles) of a blood parameter derived from a defined healthy population, used to interpret individual test results.
Complete blood count (CBC): A set of blood tests measuring cellular components—red cells, white cells, haemoglobin, haematocrit and platelets—to assess general health and detect disorders.
Latent abnormal values exclusion (LAVE): A statistical procedure to remove values suggestive of subclinical disease when establishing reference ranges, improving the accuracy of the intervals.
Percentile: A statistical indicator that denotes the value below which a given percentage of observations in a dataset falls.
References
- Complete blood count reference intervals from a healthy adult urban population in Kenya. PLOS ONE (2018).
- Determination of Haematological Reference Ranges in Healthy Adults in Three Regions in Ghana. BioMed Research International (2019).
- CLSI-Derived Hematology and Biochemistry Reference Intervals for Healthy Adults in Eastern and Southern Africa. PLOS ONE (2009).
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