Reference Intervals for Common Laboratory Tests in Melanesian Children

Laurens Manning School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Moses Laman School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Mary Anne Townsend School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Stephen P. Chubb School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Peter M. Siba School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Ivo Mueller School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Timothy M. E. Davis School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Victoria, Australia; Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain

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Pediatric reference intervals for biochemical tests are often derived from studies in Western countries and may not be applicable to the developing world. No such intervals exist for Melanesian populations. The aim of this study was to provide specific reference intervals for children from Papua New Guinea (PNG). We assayed plasma from 327 healthy Melanesian children living in Madang Province for common biochemical and hematological analytes. We used well-validated commercially available assay methodology. Compared with reference intervals from children from Western countries and/or African children, there were substantial differences in hemoglobin, soluble transferrin receptor, ferritin, calcium, phosphate, and C-reactive protein. Differences in the upper limits of reference intervals for bilirubin and alanine aminotransferase were also observed. Available reference intervals from Western and African countries may be inappropriate in PNG and other Melanesian countries. This has implications for clinical care and safety monitoring in pharmaceutical intervention trials and vaccine studies.

Author Notes

*Address correspondence to Timothy M. E. Davis, University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia. E-mail: tdavis@cyllene.uwa.edu.au

Financial support: The National Health and Medical Research Council (NHMRC) of Australia funded the study (grant no. 513782). LM was supported by Royal Australasian College of Physicians (Basser) and NHMRC scholarships, ML a Fogarty Foundation scholarship, and TMED an NHMRC Practitioner Fellowship.

Authors' addresses: Laurens Manning and Timothy M. E. Davis, University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia, E-mails: larmens@xtra.co.nz and tdavis@cyllene.uwa.edu.au. Moses Laman, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea and University of Western Australia and School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia, E-mail: drlaman@yahoo.com. Mary Anne Townsend and Stephen P. Chubb, Biochemistry Department, PathWest Laboratory Medicine WA, Fremantle Hospital, Fremantle, Western Australia, Australia, E-mails: MaryAnne.Townsend@health.wa.gov.au and Paul.Chubb@health.wa.gov.au. Peter M. Siba, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea, E-mail: peter.siba@pngimr.org.pg. Ivo Mueller, Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Barcelona, Spain and Infection and Immunity Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia, E-mail: ivomueller@fastmail.fm.

Reprint requests: Timothy M. E. Davis, University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959, Australia, Tel: 618-9431-3229, Fax: 618-9431-2977, E-mail: tdavis@cyllene.uwa.edu.au.

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