Abstract:
Background: The manual peripheral blood smear examination is a comprehensive examination
of the blood film to detect clinically significant abnormalities in leukocyte, erythrocyte, and
platelet morphology. It is a time-consuming technique, but it is a more cost-effective and
sensitive technique than an automated hematological analyzer. On the other hand, the automated
hematology analyzer is faster, more objective, and reduces labor cost but cannot reveal the
variety of abnormal cells. This study aims to find out the correlation of peripheral blood smear
examination with RBC indices and histograms obtained from an automated hematological
analyzer in diagnosis and morphological typing of anemia.
Objective: To compare the finding of the manual peripheral blood smear examination with red
cell indices and histograms obtained from the Beckman coulter UniCel DxH-800 automated
hematological analyzer in anemic patients.
Method: A comparative cross-sectional study was conducted by using a convenient sampling
technique. A total of 250 blood samples were analyzed from July 25- Oct 25, 2022 at Jimma
medical center. About 3 ml of blood samples were collected for the analysis into an EDTA
anticoagulated tube. Kappa statistics were used to measure the agreement between the two
methods. The final results were presented by tables and figures.
Result: The manual peripheral blood smear examination revealed that the predominant
morphological typing of anemia was microcytic hypochromic anemia (45.2%), while normocytic
normochromic anemia (48.0%) was the most common anemia based on red cell indices and
histogram patterns obtained from the automated hematological analyzer. The sensitivity and
specificity of the red cell indices and histograms were 85.8% and 94.1% for microcytic
hypochromic anemia, 91.6% and 84.6% for normocytic normochromic anemia and 91.7% and
98.7% for macrocytic normochromic anemia respectively.
Conclusion and recommendation: There was a statistically significant difference (p=0.000)
between the manual peripheral blood smear examination and the automated hematological
analyzer. A manual peripheral blood smear examination should be used in addition to the
automated hematological analyzer for a better diagnosis and management of anemia.
