Comparison of Manual Peripheral Blood Smear Examination With RBC Indices and Histograms Obtained From Beckman Coulter Unicel Dxh-800 Automated Hematology Analyzer In Anemic Patients at Jimma Medical Center, Southwest Ethiopia

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.