**Acknowledgement**

The authors would like to acknowledge Kayla Laserson and Laurie Kamimoto and Professor Barbara Bains for their thorough review of this chapter. The authors would also like to appreciate vital contributions made by KEMRI/CDC Kisumu, HIV-Research Laboratory. This chapter is published with the approval of the Director of KEMRI.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention. Use of trade names is for identification purposes only and does not constitute endorsement by the U.S. Centers for Disease Control and Prevention or the Department of Health and Human Services.

## **7. References**


[4] TheGlobalFund, *The Global Fund to Fight AIDS, TB and Malaria;''Global FundARVFactSheet*. 2009.

316 Blood Cell – An Overview of Studies in Hematology

**Author details** 

*Health, Kisumu, Kenya* 

**Acknowledgement** 

Human Services.

**7. References** 

183–193.

Editor. 2010, UNAIDS.

have recommended that if it is not possible to establish detailed reference studies, then validation of published reference intervals can be performed using methodology tailored for the population served by the laboratory. As few as 20 specimens can be used to validate

Given the number of clinical trials and persons receiving clinical services is expected to increase substantially in sub-Saharan Africa, there is a need for the establishment of locally derived clinical laboratory reference values to ensure appropriate general health assessment, treatment monitoring, and efficient implementation of clinical trials. Even more important is the need for the establishment of toxicity grading tables for application in clinical care among Africans based on the documented differences between laboratory reference values from African populations and Caucasians or Western populations of mixed ethnic origin.

*Centre for Global Health Research, Kenya Medical Research Institute/U.S. CDC Research and Public* 

The authors would like to acknowledge Kayla Laserson and Laurie Kamimoto and Professor Barbara Bains for their thorough review of this chapter. The authors would also like to appreciate vital contributions made by KEMRI/CDC Kisumu, HIV-Research Laboratory.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention. Use of trade names is for identification purposes only and does not constitute endorsement by the U.S. Centers for Disease Control and Prevention or the Department of Health and

[1] Esparza J, O.S., *HIV vaccines: a global perspective.* Current Molecular Medicine, 2003. 3: p.

[2] Jaoko W, N.F., Anzala O, Manyonyi GO, Birungi J, Nanvubya A, Bashir F, Bhatt K, Ogutu H, Wakasiaka S, Matu L, Waruingi W, Odada J, Oyaro M, Indangasi J, Ndinya-Achola J, Konde C, Mugisha E, Fast P, Schmidt C, Gilmour J, Tarragona T, Smith C, Barin B, Dally L, Johnson B, Muluubya A, Nielsen L, Hayes P, Boaz M, Hughes P, Hanke T, McMichael A, Bwayo J, Kaleebu P, *Safety and immunogenicity of recombinant low-dosage HIV-1 A vaccine candidates vectored by plasmid pTHr DNA or modified vaccinia* 

*virus Ankara (MVA) in humans in East Africa.* Vaccine, 2008. 26(22): p. 2788–2795. [3] UNAIDS, *Report on the global AIDS epidemic. Geneva, Switzerland, WHO press*, WHO,

reference values within each laboratory by performing a formal outlier test.

*U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya,* 

This chapter is published with the approval of the Director of KEMRI.

Clement E. Zeh, Collins O. Odhiambo and Lisa A. Mills


*laboratory toxicity tables to evaluate laboratory toxicities among healthy malawian and Ugandan infants.* J Acquir Immune Defic Syndr, 2010. 55(1): p. 58-64.

Laboratory Reference Intervals in Africa 319

[36] Mwinga K, V.S., Chen YQ, Mwatha A, Read JS, Urassa W, Carpenetti N, Valentine M, Goldenberg R L, *Selected hematologic and biochemical measurements in African HIV-infected and uninfected pregnant women and their infants: the HIV Prevention Trials Network 024* 

[37] Shahabuddin, S., *Quantitative differences in CD8+ lymphocytes, CD4/CD8 ratio, NK cells, and HLA-DR(+)-activated T cells of racially different male populations.* Clin Immunol

[38] Hsieh MM, E.J., Byrd-Holt DD, Tisdale JF, Rodgers GP, *Prevalence of Neutropenia in the U.S. Population: Age, Sex, Smoking Status, and Ethnic Differences.* Annals of Internal

[39] Saathoff E, S.P., Kleinfeldt V, Geis S, Haule D, Maboko L, Samky E, de Souza M, Robb M, Hoelscher M, *Laboratory reference values for healthy adults from southern Tanzania.* Trop

[40] Tsegaye A, M.T., Tilahun T, Hailu E, Sahlu T, Doorly R, Fontanet AL, Rinke de Wit TF, *Immunohematological reference ranges for adult Ethiopians.* Clin Diagn Lab Immunol 1999.

[41] Koram KA, A.M., Ocran JC, Adu-Amankwah S, Rogers WO, Nkrumah F K, *Population based reference intervals for common blood haematological and biochemical parameters in the* 

[42] Menard D, M.M., Tothy MB, Kelembho EK, Gresenguet G, Talarmin A, *Immunohematological reference ranges for adults from the Central African Republic.* Clin

[43] Gordon AS, M.E., Wenig J, Katz R, Zanjani ED, *Androgen actions on erythropoiesis.* Annals

[44] Krabbe S, C.T., Worm J, Christiansen C, Transbol I *Relationship between haemoglobin and serum testosterone in normal children and adolescents and in boys with delayed puberty.* Acta

[45] Hawkins WW, S.E., Leonard VG, *Variation of the hemoglobin level with age and sex.* Blood,

[46] Gardener FH, N.D., Piomelli S, Cummins JF, *The erythrocythaemic effects of androgens.*

[47] Daniel, W., *Hematocrit: maturity relationship in adolescence.* . Pediatrics, 1973. 52(3): p. 388-

[48] Troy SB, R.-R.A., Le Dyner L, Musingwini G,. Shetty AK, Woelk G, Stranix-Chibanda L, Nathoo K. Maldonado YA, *Hematologic and Immunologic Parameters in Zimbabwean Infants: A Case for Using Local Reference Intervals to Monitor Toxicities in Clinical Trials.* J

[49] Saxena S, W.E., *Heterogeneity of common hematologic parameters among racial, ethnic, and gender subgroups.* Archives of Pathology and Laboratory Medicine, 1990. 114: p. 715–719. [50] Tikly M, B.D., Solomons HD, Govender Y, Atkinson PM, *Normal haematological reference values in the adult black population of the Witwatersrand.* S Afr Med J, 1987. 72(2): p. 135-

[51] Ezeilo, G., *Non-genetic neutropenia in Africans. .* Lancet 1972. 300(7785): p. 1003-1005. [52] Orfanakis NG, O.R., Bishop CR, Athens JW, *Normal blood leukocyte concentration values.*

*Akuapem north district.* Ghana Medical Journal, 2007. 41(4): p. 160-166.

of the New York Academy of Sciences, 1968. 149: p. 318–335.

British Journal of Haematology, 1968. 14(6): p. 611–615.

*protocol.* BMC Pediatr, 2009. 9.

Immunopathol, 1995. 75: p. 168–170.

Medicine, 2007. 146(7): p. 486-492.

Med Int Health, 2008. 13: p. 612–625.

Diagn Lab Immunol, 2003. 10: p. 443–445.

Paediatr Scand, 1978. 67: p. 655–658.

Trop Pediatr 2011. 58(1): p. 59-62.

Am J Clin Pathol, 1970. 53: p. 647-651.

1954. 9(10): p. 999-1007.

394.

136.

6: p. 410–414.


[36] Mwinga K, V.S., Chen YQ, Mwatha A, Read JS, Urassa W, Carpenetti N, Valentine M, Goldenberg R L, *Selected hematologic and biochemical measurements in African HIV-infected and uninfected pregnant women and their infants: the HIV Prevention Trials Network 024 protocol.* BMC Pediatr, 2009. 9.

318 Blood Cell – An Overview of Studies in Hematology

*laboratory toxicity tables to evaluate laboratory toxicities among healthy malawian and* 

[20] Karita E, K.N., Price MA, Kayitenkore K, Kaleebu P, Nanvubya A, Anzala O, Jaoko W, Mutua G, Ruzagira E, Mulenga J, Sanders EJ, Mwangome M, Allen S, Bwanika A, Bahemuka U, Awuondo K, Omosa G, Farah B, Amornkul P, Birungi J, Yates S, Stoll-Johnson L, Gilmour J, Stevens G, Shutes E, Manigart O, Hughes P, Dally L, Scott J, Stevens W, Fast P, Kamali A, *CLSI derived hematology and biochemistry reference intervals* 

[21] NCCLS, *How to define and determine reference intervals in the clinical laboratory; approved* 

[22] Reed AH, H.R., Mason WB, *Influence of statistical methods used on the resulting estimate of* 

[23] Horn PS, H.G., Pesce AJ, *Determining Laboratory Reference Intervals: CLSI Guideline Makes* 

[24] Gill GV, E.A., Marshal C, *Low platelet counts in Zambians.* Transactions of the Royal

[25] Lugada ES, M.J., Kaharuza F, Ulvestad E, Were W, Langeland N, Asjo B, Malamba S, Downing R, *Population-based hematologic and immunologic reference values for a healthy* 

[26] Tugume SB, P.E., Lutalo T, Mugyenyi PN, Grant RM, Mangeni FW, Pattishall K, Katongole-Mbidde E, *Hematological reference ranges among healthy Ugandans.* Clin Diagn

[30] Bain B, S.M., Godsland I, *Normal values for peripheral blood white cell counts in women of* 

[31] Ngowi BJ, M.S., Bruun JN, Morkve O . , . 9: p. 1., *Immunohaematological reference values in human immunodeficiency virus-negative adolescent and adults in rural northern Tanzania.*

[32] Choong ML, T.S., Cheong SK, *Influence of race,age and sex on the lymphocyte sub-sets in peripheral blood of healthy Malaysian adults. .* Annals of clinical biochemistry, 1995. 32(6):

[33] Lee BW, Y.H., Chew FT, Quah TC, Prabhakaran K, Chan GS, Wong SC, Seah CC, *Ageand sex-related changes in lymphocyte subpopulations of healthy Asian subjects: from birth to* 

[34] Romeo J, W.J., Gomez-Martinez S, Diaz LE, Moreno LA, Castillo MJ, Redondo C, Baraza JC, Sola R, Zamora S, Marcos A, . , . 83: p. . *Haematological reference values in Spanish adolescents: the AVENA study.* European Jounal of haematology, 2009. 83: p. 586–594. [35] Shahabuddin, S., *Quantitative differences in CD8+ lymphocytes, CD4/CD8 ratio, NK cells, and HLA-DR(+)-activated T cells of racially different male populations.* Clin Immunol

*four different ethnic origins.* Journal of Clinical Pathology, 1984. 37: p. 188-193.

[27] Morley, A., *A platelet cycle in normal individuals.* Aust Ann Med, 1969. 18: p. 127-133. [28] Haddy TB, R.S., Castro O, *Benign ethnic neutropenia: what is a normal absolute neutrophil count?* The Journal of Laboratory and Clinical Medicine, 1999. 133(1): p. 15-22. [29] Abdulkadir J, B.G., *Haemoglobin and haematocrit levels in young adult Ethiopian males in* 

*Ugandan infants.* J Acquir Immune Defic Syndr, 2010. 55(1): p. 58-64.

*for healthy adults in eastern and southern Africa.* PLoS One, 2009. 4(2).

*the Task Manageable.* Laboratory Medicine, 2009. 40(2): p. 75-76.

Society of Tropical Medicine and Hygiene, 1979. 73(1): p. 111-112.

*Ugandan population.* Clin Diagn Lab Immunol, 2004. 11: p. 29-34.

*Addis Ababa.* Ethiopian Medical Journal 1979. 17: p. 5–8.

*normal range.* Clin. Chem, 1971. 17: p. 275-284.

Lab Immunol, 1995. 2: p. 233–235.

BMC Infect Dis, 2009. 9(1).

*adulthood.* Cytometry, 1996. 26(1): p. 8-15.

Immunopathol 1995. 75: p. 168–170.

p. 532–539.

*guideline*. 2000, National Committee for Clinical laboratory Standards


[53] Shaper AG, L.P., *Genetic neutropenia in people of African origin.* Lancet, 1971. 2: p. 1021– 1023.

**Chapter 16** 

© 2012 Mamak and Aytekin, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2012 Mamak and Aytekin, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

**Principles of Blood Transfusion** 

Additional information is available at the end of the chapter

The aim of this chapter is to present a revised overview of small and large animal transfusion medicine based on a review of the veterinary literature. Blood transfusion has become more performable in small and large animal practice. By donor selection and the availability of blood component substitutes, usage of the blood products improved. The use of blood component therapy safely needed knowledge of blood groups, antibody prevalence and the impact of blood groups on veterinary transfusion medicine. Animal blood transfusions antibodies against blood group antigens also play a role. In addition knowledge of the means to decrease the risk of adverse reactions by using proper donors and screening assays that simplify detection of serological incompatibility is important. The clinical significance of blood group antigens in veterinary medicine is generally in the areas of transfusion reactions and neonatal isoerythrolysis (NI). This chapter includes an update on canine and feline, horse, donkey, cattle, sheep, gaot, pig, llama and alpaca blood groups and known blood incompatibilities, donor selection and blood collection, storage of blood components, available equine blood products and indications for transfusion, whole blood (WB) and blood product transfusion in ruminants and camelids, blood component and blood substitute therapy, administration, and adverse reactions in small and large animal

Blood types are classified according to specific antigens on the surface of erythrocytes. Platelets, leukocytes, and body tissues and fluids may also consists of erytrocyte antigens. [1]. In immunogenicity and clinical significance these antigens can differ. They can serve as markers of disease in some cases and taking part in recognition of self. The clinical significance of blood group antigens is generally noted in transfusion reactions and neonatal isoerythrolysis (NI) in veterinary medicine [2]. These antigens can characteristically trigger a reaction caused by circulating anti-erythrocyte antibodies in the opposite host or donor.

Nuri Mamak and İsmail Aytekin

http://dx.doi.org/10.5772/48332

**1. Introduction** 

blood transfusion.

**2. Blood types in dogs and cats** 

