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Haematology



The Haematology Department offers laboratory services to which both hospital doctors and general practitioners have open access.

Much of the work is automated and in particular the blood count is analysed by the latest technology the sysmex XT 1800i. This is an automated hematology analyzer that outputs 21 parameters of a blood sample. The accuracy of the measurements is ensured by an internal quality control system. Sample identification and safety is made easier by an in built barcode reader. Transcirption Errors are also taken care of by the interface through which results are electronically transferred from the machine to DML system. This equipment provides a fast and efficient method for Full Blood Count (FBC) analysis. Most of the laboratory work is fully computerized.

Erythrocyte Sedimentation Rate (ESR) determination is done using the Test I (ALIFAX) machine. It utilizes an analytical principle known as the photometrical capillary stopped flow kinetic analysis. The results obtained by this technique are comparable to those of the Westergren method (the gold standard) with a correlation coefficient of 0.919. The difference in results obtained by both methods is clinically insignificant in most cases. Unlike the westergren method which takes an hour to get results the Test I method can have a result in three minutes with 60 samples processed in 20 minutes.

Routine and most special tests are done on the site though we do refer some special investigations to referral laboratories in South Africa , so that a fully comprehensive service is available. The laboratory participates in all the national quality control schemes that cover each area of hematology thus quality control is constantly monitored to ensure that highest standards are maintained.

This department provides the full automated blood count which includes hemoglobin, MCV, white count (with automated differential) and platelet count. This section also performs ESR, reticulocytes and blood film comments, including malarial screen.

  A screening service.

  Diagnosis of the simple anaemias backed up by the Biochemistry Department; in particular we aim to help the clinician in differentiating the causes of a microcytic anaemia (iron deficiency or chronic disorder) with the help of ESR and ferritin, and the macrocytic anaemias.

  The diagnosis of primary hematological disorders.

  Some help for the clinician in highlighting where significant non-hematological disease is present and manifest in either an abnormal blood count or ESR.

  Monitoring of treatment particularly in areas where the blood count may be affected, such as chemotherapy.

  Despite modern technology the blood film is still an essential diagnostic tool in hematology; it is in this area that a few clinical details are particularly helpful and so also provide this service.

These include:
Coagulation section where the following tests are provided:

  Monitoring treatment by the APTT and INR respectively.

  The diagnosis and management of either congenital or acquired bleeding disorders; the former includes hemophilia, the latter the bleeding problems in the critically ill, of obstetric patients and those with liver failure.

  Platelet function tests including the bleeding time.

  Thrombophilia screen, including the lupus anticoagulant, anti-thrombin III, protein S, protein C, resistance to activated protein C and anti-cardiolipin antibody.


Special Investigations sent to referral laboratories


  Cell surface marker studies on peripheral blood and bone marrow particularly helpful in differentiating between a reactive polyclonal and a monoclonal neoplastic lymphocytosis.

  Cytogenetics of peripheral blood and bone marrow in presumed bone marrow disorders.

  HLA typing / tissue typing service

  Erythropoietin

  Hemoglobin electrophoresis for sick cell anemia screen and thalassaemia screen.

  Red cell enzyme studies including G6PD levels.

  Other special investigations include special stains for hematological malignancies.

Results from routine blood count and simple coagulation tests are available, usually on the day of receipt of the sample and invariably within 24-hours.