Comparison of haemoglobinometry by WHO Haemoglobin Colour Scale and copper sulphate against haemiglobincyanide reference method.

Although estimation of haemoglobin is essential for diagnosing anaemia and assessing its severity, many health centres in developing countries do not have the facilities for haemoglobinometry. The WHO Haemoglobin Colour Scale (HCS) method is a simple and inexpensive clinical device that was recently developed in order to diagnose anaemia in such centres. In Indonesia, the copper sulphate specific gravity method is used for blood donor screening and also in primary health clinics in the rural and remote areas. In this study, the HCS method is compared with the copper sulphate method and with an earlier paper scale, the Tallquist method, against the standard haemiglobincyanide spectrophotometric method. The HCS method showed an acceptable level of precision and accuracy for use as a reliable screening tool to diagnose anaemia in patients and also for blood donor screening.

Proposed evaluation of laboratory performance in an external hematology quality control scheme.

The commercial control material for hematology Cell Dyn 16 Tri Level gave a good precision an accuracy using the four blood cell counters currently mostly used in Indonesia, the Coulter, Sysmex, Serono and Cell Dyn. It could be used as one of the hematology control material in an external quality control scheme. Result of the CV from participating laboratories are higher compared to this trial are caused by different level of laboratory technical ability although the geographical area and climate may also play a role. The new scoring calculation to evaluate the participant's performance gave a more wider range of DI scores, to give better insight to the performance of each laboratory.

Country report: the Indonesian NEQAS on hematology. National External Quality Assessment Scheme.

Around six hundred clinical laboratories in all the province of Indonesia participated the Indonesian National External Quality Assessment Scheme (NEQAS) on Hematology (Program Nasional Pemantapan Kualitas Laboratorium Klinik bidang Hematologi). Automated analyzer gave better results compared to the manual method. For hemoglobin, the CV of automated analyzer and manual method were 2.8% and 9.1%, respectively. The CV of automated analyzer and manual method for leukocyte count were 8.3% and 32.3%; for erythrocyte count were 9.7% and 80.8%; and for thrombocyte count were 10.3% and 45.9%. We observe no significant improvement of the overall performance from 1986 to 1998. Quality control material for NEQAS on hematology is still a problem. The artificial particles seem not behave exactly like the human cells (leukocytes, thrombocytes).

Field evaluation of who hemoglobin color scale in West Java.

The results obtained with a WHO hemoglobin (Hb) colour scale were evaluated in a field study in Chibubur district in Java island by comparison with hemoglobin values obtained by an automated blood cell analyzer K-800 (Sysmex. Kobe, Japan). When the color scale test was performed following the instructions for use. Hb values observed were usually higher than the values obtained by the analyzer. Thirty microl blood was loaded on the filter paper and an 60 sec waiting period was used. The sensitivity of results obtained with the color scale was 23.3% (14/60), and specificity was 96.6% (58/60). We propose an additional testing method based on our results.

PF3 activity in normal subjects and beta-thalassemia trait.

Platelet factor 3 (PF3) is a platelet membrane component that plays an important role in the activation of the coagulation mechanism. Whenever platelet activation occurred, PF3 is released and participates in thrombin formation. Erythrocyte membrane fraction has also some PF3 like activity, and in abnormal erythrocyte membrane disorders, eg thalassemia, some of the membrane fraction accelerates platelet activation by increasing the PF3 activity. Formerly it was difficult to measure the PF3 activity in plasma. Recently a sensitive chromogenic test to determine the PF3 activity, which could detect the changes in PF3 activity with time, was introduced. This study was done to observe the effect of abnormal erythrocyte on platelet activation. The results obtained using the chromogenic method are the following: whole blood taken from normal subjects showed OD 0.11 +/- 0.06 at 0 minutes after blood collection and then increased significantly (p < 0.01) to 0.21 +/- 0.10 after 90 minutes, while the platelet count did not differ significantly (p > 0.05). Those results showed that there were some platelet activation after 90 minutes as seen by the increased PF3 activity, with no significant change in platelet counts. In beta-thalassemic trait subjects the PF3 activity in whole blood at 0 minutes did not differ significantly compared to the normal subjects, but after 90 minutes it was significantly higher (p < 0.01), OD 0.52 +/- 0.35. However the PF3 in platelet rich plasma at 90 minutes did not increase. The platelet count after 90 minutes was significantly decreased (p < 0.01) This result suggest that the increase in PF3 activity was caused by the role of the abnormal erythrocytes.

Hepatitis C among blood donors in Jakarta.

One type of non-A non-B hepatitis (NANBH) is caused by hepatitis C virus (HCV), and is mostly transmitted through blood transfusion or its components. The prevalence of NANBH among post transfusion hepatitis (PTH) in Western countries is around 90-95%. After Chiron had identified the viral protein which caused parenteral NANBH or HCV, it became possible to detect the antibody for HCV as a sign of its transmission. In Indonesia, the usage of blood and its components gradually increased every year. Since 1985, all blood components from the Indonesian Red Cross were screened against hepatitis B virus (HBV), and it was found that most of the post-transfusion hepatitis were caused by HCV. In this study, the prevalence of the HCV antibody in blood donors was 3 out of 193 (1.6%) using the ELISA method (Ortho).