{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:58:05Z","timestamp":1785038285550,"version":"3.55.0"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006751","name":"U.S. Army","doi-asserted-by":"publisher","award":["W81XWH-11-2-0174"],"award-info":[{"award-number":["W81XWH-11-2-0174"]}],"id":[{"id":"10.13039\/100006751","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006751","name":"U.S. Army","doi-asserted-by":"publisher","award":["W81XWH-18-2-0040"],"award-info":[{"award-number":["W81XWH-18-2-0040"]}],"id":[{"id":"10.13039\/100006751","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Clinical laboratory reference intervals (RIs) are essential for diagnosing and managing patients in routine clinical care as well as establishing eligibility criteria and defining adverse events in clinical trials, but may vary by age, gender, genetics, nutrition and geographic location. It is, therefore, critical to establish region-specific reference values in order to inform clinical decision-making.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We analyzed data from a prospective observational HIV incidence cohort study in Kombewa, Kenya. Study participants were healthy males and females, aged 18\u201335 years, without HIV. Median and 95% reference values (2.5<jats:sup>th<\/jats:sup>percentile to 97.5<jats:sup>th<\/jats:sup>percentile) were calculated for laboratory parameters including hematology, chemistry studies, and CD4 T cell count. Standard Deviation Ratios (SDR) and Bias Ratios (BR) are presented as measures of effect magnitude. Findings were compared with those from the United States and other Kenyan studies.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>A total of 299 participants were analyzed with a median age of 24 years (interquartile range: 21\u201328). Ratio of males to females was 0.9:1. Hemoglobin range (2.5<jats:sup>th<\/jats:sup>\u201497.5<jats:sup>th<\/jats:sup>percentiles) was 12.0\u201317.9 g\/dL and 9.5\u201315.3 g\/dL in men and women respectively. In the cohort, MCV range was 59-95fL, WBC 3.7\u20139.2\u00d710<jats:sup>3<\/jats:sup>\/\u03bcL, and platelet 154\u2013401\u00d710<jats:sup>3<\/jats:sup>\/\u03bcL. Chemistry values were higher in males; the creatinine RI was 59\u2013103 \u03bcmol\/L in males vs. 46\u201376 \u03bcmol\/L in females (BRUL&gt;.3); and the alanine transferase range was 8.8\u201345.3 U\/L in males vs. 7.5\u201336.8 U\/L in females (SDR&gt;.3). The overall CD4 T cell count RI was 491\u20131381 cells\/\u03bcL. Some parameters including hemoglobin, neutrophil, creatinine and ALT varied with that from prior studies in Kenya and the US.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>This study not only provides clinical reference intervals for a population in Kisumu County but also highlights the variations in comparable settings, accentuating the requirement for region-specific reference values to improve patient care, scientific validity, and quality of clinical trials in Africa.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0249259","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T17:35:41Z","timestamp":1617125741000},"page":"e0249259","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical laboratory reference values in adults in Kisumu County, Western Kenya; hematology, chemistry and CD4"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9434-9630","authenticated-orcid":true,"given":"Valentine","family":"Sing\u2019oei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jew","family":"Ochola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Owuoth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Andagalu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4514-330X","authenticated-orcid":true,"given":"Chiaka","family":"Nwoga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathanial K.","family":"Copeland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lawlor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6045-8334","authenticated-orcid":true,"given":"Adam","family":"Yates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Imbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-265X","authenticated-orcid":true,"given":"Trevor A.","family":"Crowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh Anne","family":"Eller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Kamau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-5572","authenticated-orcid":true,"given":"Kayvon","family":"Modjarrad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Cowden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Ake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin L.","family":"Robb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9801-2012","authenticated-orcid":true,"given":"Christina S.","family":"Polyak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"issue":"3","key":"pone.0249259.ref001","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1093\/inthealth\/ihw021","article-title":"Non-communicable diseases in sub-Saharan Africa: understanding the drivers of the epidemic to inform intervention strategies.","volume":"8","author":"MJ Nyirenda","year":"2016","journal-title":"Int Health"},{"key":"pone.0249259.ref002","article-title":"Kenya National Strategy for the Prevention and control of non-communicable diseases.","author":"Kenyan Ministry of Public Health","year":"2015","journal-title":"Kenya Natl Strateg."},{"issue":"1","key":"pone.0249259.ref003","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/nrd2441","article-title":"Trends in the globalization of clinical trials.","volume":"7","author":"FA Thiers","year":"2008","journal-title":"Nat Rev Drug Discov"},{"issue":"1","key":"pone.0249259.ref004","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4269\/ajtmh.20-0541","article-title":"Attaining 95-95-95 through implementation science: 15 years of insights and best practices from the walter reed army institute of research\u2019s implementation of the U.S. president\u2019s emergency plan for AIDS relief.","volume":"104","author":"EH Lee","year":"2021","journal-title":"Am. J. Trop. Med. Hyg."},{"issue":"22","key":"pone.0249259.ref005","doi-asserted-by":"crossref","first-page":"2788","DOI":"10.1016\/j.vaccine.2008.02.071","article-title":"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.","volume":"26","author":"W Jaoko","year":"2008","journal-title":"Vaccine"},{"issue":"1","key":"pone.0249259.ref006","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1128\/CDLI.11.1.29-34.2004","article-title":"Population-Based Hematologic and Immunologic Reference Values for a Healthy Ugandan Population","volume":"11","author":"ES Lugada","year":"2004","journal-title":"Clin Diagn Lab Immunol"},{"issue":"4","key":"pone.0249259.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0123140","article-title":"Evaluation of locally established reference intervals for hematology and biochemistry parameters in Western Kenya.","volume":"10","author":"C Odhiambo","year":"2015","journal-title":"PLoS One"},{"issue":"5","key":"pone.0249259.ref008","doi-asserted-by":"crossref","first-page":"e97391","DOI":"10.1371\/journal.pone.0097391","article-title":"Reference values for clinical laboratory parameters in young adults in Maputo, Mozambique.","volume":"9","author":"N Tembe","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"pone.0249259.ref009","doi-asserted-by":"crossref","first-page":"e93919","DOI":"10.1371\/journal.pone.0093919","article-title":"Comprehensive reference ranges for hematology and clinical chemistry laboratory parameters derived from normal Nigerian adults","volume":"9","author":"T Miri-Dashe","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"pone.0249259.ref010","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/j.1365-3156.2008.02047.x","article-title":"Laboratory reference values for healthy adults from southern Tanzania","volume":"13","author":"E Saathoff","year":"2008","journal-title":"Trop Med Int Heal"},{"issue":"3","key":"pone.0249259.ref011","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1128\/CDLI.6.3.410-414.1999","article-title":"Immunohematological reference ranges for adult ethiopians","volume":"6","author":"A Tsegaye","year":"1999","journal-title":"Clin Diagn Lab Immunol"},{"issue":"3","key":"pone.0249259.ref012","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1128\/CDLI.10.3.443-445.2003","article-title":"Immunohematological reference ranges for adults from the Central African Republic","volume":"10","author":"D Menard","year":"2003","journal-title":"Clin Diagn Lab Immunol"},{"issue":"6","key":"pone.0249259.ref013","doi-asserted-by":"crossref","first-page":"e21040","DOI":"10.1371\/journal.pone.0021040","article-title":"Population-based biochemistry, immunologic and hematological reference values for adolescents and young adults in a rural population in Western Kenya.","volume":"6","author":"C Zeh","year":"2011","journal-title":"PLoS One."},{"issue":"10","key":"pone.0249259.ref014","doi-asserted-by":"crossref","first-page":"e3327","DOI":"10.1371\/journal.pone.0003327","article-title":"Reference ranges for the clinical laboratory derived from a rural population in Kericho, Kenya.","volume":"3","author":"RS Kibaya","year":"2008","journal-title":"PLoS One"},{"issue":"1","key":"pone.0249259.ref015","doi-asserted-by":"crossref","first-page":"e14580","DOI":"10.1371\/journal.pone.0014580","article-title":"Reasons for ineligibility in phase 1 and 2A HIV vaccine clinical trials at Kenya Aids Vaccine Initiative (KAVI), Kenya.","volume":"6","author":"GS Omosa-Manyonyi","year":"2011","journal-title":"PLoS One."},{"issue":"3","key":"pone.0249259.ref016","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s40142-013-0017-3","article-title":"Genetics of Population Differences in Drug Response","volume":"1","author":"M Bachtiar","year":"2013","journal-title":"Curr Genet Med Rep"},{"issue":"9237","key":"pone.0249259.ref017","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0140-6736(00)02799-9","article-title":"Adverse drug reactions: definitions, diagnosis, and management","volume":"356","author":"IR Edwards","year":"2000","journal-title":"Lancet"},{"key":"pone.0249259.ref018","volume-title":"Pediatric and Neonatal Dosage Handbook","author":"JT DiPiro","year":"2007","edition":"21"},{"key":"pone.0249259.ref019","unstructured":"Coulter B. Coulter \u00ae a. 2010."},{"key":"pone.0249259.ref020","unstructured":"2019 Kenya Population and Housing Census Results\u2014Kenya National Bureau of Statistics."},{"key":"pone.0249259.ref021","unstructured":"National Malaria Control Programme M of H. Kenya Malaria Indicator Survey 2015. 2015;2."},{"key":"pone.0249259.ref022","unstructured":"National AIDS and STI Control Programs (NASCOP). Kenya HIV Estimates Report 2018."},{"key":"pone.0249259.ref023","unstructured":"NCCLS (2000) How to define and determine reference intervals in the clinical laboratory; approved guideline-Second Edition. National Committee for Clinical Laboratory Standards, Wayne, PA C28-A2, Vol. 20 No 13. 2ed."},{"key":"pone.0249259.ref024","volume-title":"Ministry of Health, Kenya","author":"National AIDS and STI Control Programme","year":"2015"},{"issue":"4","key":"pone.0249259.ref025","first-page":"500","volume":"99","author":"WPO Meara","year":"2008","journal-title":"Systematic comparison of two methods to measure parasite density from malaria blood smears"},{"issue":"2","key":"pone.0249259.ref026","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/j.2517-6161.1964.tb00553.x","article-title":"An Analysis of Transformations.","volume":"26","author":"GEP Box","year":"1964","journal-title":"J R Stat Soc Ser B."},{"key":"pone.0249259.ref027","unstructured":"JW T. Tukey, J.W. (1977) Exploratory Data Analysis, EDA. Addison-Wesley, Reading, MA."},{"issue":"11","key":"pone.0249259.ref028","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1515\/CCLM.2010.319","article-title":"An appraisal of statistical procedures used in derivation of reference intervals","volume":"48","author":"K Ichihara","year":"2010","journal-title":"Clin Chem Lab Med"},{"key":"pone.0249259.ref029","article-title":"Title: Establishment of Reference Intervals of Clinical Chemistry Analytes for the Adult Population in Egypt.","author":"H Baz","journal-title":"bioRxiv"},{"issue":"7","key":"pone.0249259.ref030","doi-asserted-by":"crossref","first-page":"e0235234","DOI":"10.1371\/journal.pone.0235234","article-title":"Determination of reference intervals for common chemistry and immunoassay tests for Kenyan adults based on an internationally harmonized protocol and up-to-date statistical methods","volume":"15","author":"G Omuse","year":"2020","journal-title":"PLoS One."},{"key":"pone.0249259.ref031","first-page":"1","author":"G Omuse","year":"2018","journal-title":"Complete blood count reference intervals from a healthy adult urban population in Kenya"},{"key":"pone.0249259.ref032","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1056\/NEJMcpc049016","article-title":"Laboratory reference values.","volume":"351","author":"A Kratz","year":"2004","journal-title":"New England Journal of Medicine"},{"key":"pone.0249259.ref033","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1136\/jcp.37.2.188","article-title":"Normal values for peripheral blood white cell counts in women of four different ethnic origins","volume":"37","author":"B Bain","year":"1984","journal-title":"J Clin Pathol"},{"issue":"2","key":"pone.0249259.ref034","doi-asserted-by":"crossref","first-page":"e4401","DOI":"10.1371\/journal.pone.0004401","article-title":"CLSI-derived hematology and biochemistry reference intervals for healthy adults in eastern and southern Africa","volume":"4","author":"E Karita","year":"2009","journal-title":"PLoS One"},{"issue":"1","key":"pone.0249259.ref035","first-page":"58","article-title":"White blood cell count in women: Relation to inflammatory biomarkers, haematological profiles, visceral adiposity, and other cardiovascular risk factors.","volume":"31","author":"MA Farhangi","year":"2013","journal-title":"Saboor-Yaraghi Dr. AA.J Heal Popul Nutr."},{"key":"pone.0249259.ref036","first-page":"77","author":"BJ Bain","year":"1985","journal-title":"Platelet count and platelet size in males and females"},{"key":"pone.0249259.ref037","unstructured":"Sheet F, Day WA, People V. Global HIV statistics. 2019;(June)."},{"key":"pone.0249259.ref038","unstructured":"WHO\/CDS\/TB\/2019.15. Global tuberculosis report. 1392."},{"key":"pone.0249259.ref039","unstructured":"WHO. World malaria report 2020."},{"issue":"8","key":"pone.0249259.ref040","doi-asserted-by":"crossref","first-page":"761","DOI":"10.2174\/156652405774962344","article-title":"Ebola and Marburg Viruses: Pathogenesis and Development of Countermeasures","volume":"5","author":"L Hensley","year":"2005","journal-title":"Curr Mol Med"},{"issue":"4","key":"pone.0249259.ref041","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/cid\/ciy981","article-title":"Noninfectious Comorbidity in the African Cohort Study","volume":"69","author":"JA Ake","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"6","key":"pone.0249259.ref042","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1152\/ajpendo.2001.281.6.E1172","article-title":"Testosterone dose-response relationships in healthy young men.","volume":"281","author":"S Bhasin","year":"2001","journal-title":"Am J Physiol\u2014Endocrinol Metab"},{"issue":"2","key":"pone.0249259.ref043","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1152\/ajplegacy.1966.210.2.315","article-title":"Mechanism of action of androgens on erythropoiesis","volume":"210","author":"J Naets","year":"1966","journal-title":"Am J Physiol Content"},{"issue":"3","key":"pone.0249259.ref044","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/(SICI)1096-8644(199807)106:3<385::AID-AJPA10>3.0.CO;2-X","article-title":"Hemoglobin concentration of high-altitude Tibetans and Bolivian Aymara","volume":"106","author":"CM Beall","year":"1998","journal-title":"Am J Phys Anthropol"},{"key":"pone.0249259.ref045","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1136\/pgmj.2006.049734","article-title":"Heights and haematology: The story of haemoglobin at altitude.","volume":"83","author":"JS Windsor","year":"2007","journal-title":"Postgraduate Medical Journal"},{"issue":"7","key":"pone.0249259.ref046","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1136\/jcp.49.8.664","article-title":"Ethnic and sex differences in the total and differential white cell count and platelet count","volume":"49","author":"BJ Bain","year":"1996","journal-title":"Clin Pathol"},{"issue":"0","key":"pone.0249259.ref047","first-page":"1","article-title":"Iron De fi ciency Generates Secondary Thrombocytosis and Platelet Activation in IBD: the Randomized, Controlled ThromboVIT Trial.","volume":"0","author":"S Kulnigg-dabsch","year":"2013","journal-title":"Inflamm Bowel Dis"},{"issue":"5","key":"pone.0249259.ref048","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3109\/09537104.2012.699641","article-title":"The relationship between iron parameters and platelet parameters in women with iron deficiency anemia and thrombocytosis.","volume":"24","author":"M Park","year":"2013","journal-title":"Platelets"},{"issue":"4","key":"pone.0249259.ref049","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002784","article-title":"Low Levels of Awareness Despite High Prevalence of Schistosomiasis among Communities in Nyalenda Informal Settlement, Kisumu City, Western Kenya.","volume":"8","author":"GO Odhiambo","year":"2014","journal-title":"PLoS Negl Trop Dis."},{"issue":"3","key":"pone.0249259.ref050","doi-asserted-by":"crossref","first-page":"318","DOI":"10.4269\/ajtmh.2003.69.318","article-title":"Geographic distribution of schistosomiasis and soil- transmitted helminths in Western Kenya: Implications for antihelminthic mass treatment","volume":"69","author":"T Handzel","year":"2003","journal-title":"Am J Trop Med Hyg"},{"issue":"3","key":"pone.0249259.ref051","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2174\/1874241601003010066","article-title":"Reference ranges for serum biochemical parameters among healthy Cameroonians to support HIV vaccine and related clinical trials","volume":"3","author":"GA Alemnji","year":"2010","journal-title":"Open Clin Chem J"},{"issue":"11","key":"pone.0249259.ref052","first-page":"709","article-title":"Mildly Elevated Liver Transaminase Levels: Causes and Evaluation.","volume":"96","author":"RC Oh","year":"2017","journal-title":"Am Fam Physician"},{"issue":"3","key":"pone.0249259.ref053","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.mad.2005.11.001","article-title":"Accumulation of memory T cells from childhood to old age: Central and effector memory cells in CD4+ versus effector memory and terminally differentiated memory cells in CD8+ compartment","volume":"127","author":"P Saule","year":"2006","journal-title":"Mech Ageing Dev"},{"issue":"3","key":"pone.0249259.ref054","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1046\/j.0902-4441.2003.00199.x","article-title":"Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland","volume":"72","author":"LR Bisset","year":"2004","journal-title":"Eur J Haematol"},{"issue":"84","key":"pone.0249259.ref055","first-page":"499","article-title":"An Italian national multicenter study for the definition of a reference ranges for normal values of peripheral blood lymphocyte subsets in healthy adults","author":"R Cells","year":"1999","journal-title":"Haematologica"},{"issue":"1","key":"pone.0249259.ref056","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2174\/1874613601105010074","article-title":"Normal Range of CD4 Cell Counts and Temporal Changes in Two HIV Negative Malawian Populations.","volume":"5","author":"C A.C.","year":"2011","journal-title":"Open AIDS J"},{"issue":"2","key":"pone.0249259.ref057","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.clim.2005.03.020","article-title":"Lymphocyte subsets\u2019 reference ranges in an age- and gender-balanced population of 100 healthy adults\u2014A monocentric German study","volume":"116","author":"K Jentsch-Ullrich","year":"2005","journal-title":"Clin Immunol"},{"issue":"1","key":"pone.0249259.ref058","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1128\/CDLI.11.1.168-173.2004","article-title":"Establishment of Adult Peripheral Blood Lymphocyte Subset Reference Range for an Asian Population by Single-Platform Flow Cytometry: Influence of Age, Sex, and Race and Comparison with Other Published Studies","volume":"11","author":"WJ Chng","year":"2004","journal-title":"Clin Diagn Lab Immunol"},{"issue":"6","key":"pone.0249259.ref059","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1128\/CDLI.8.6.1171-1176.2001","article-title":"Distribution of lymphocyte subsets in healthy human immunodeficiency virus-negative adult Ethiopians from two geographic locales","volume":"8","author":"A Kassu","year":"2001","journal-title":"Clin Diagn Lab Immunol"},{"issue":"6","key":"pone.0249259.ref060","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1128\/CVI.00044-07","article-title":"Immunohematological reference values for healthy adults in Burkina Faso.","volume":"14","author":"N Klose","year":"2007","journal-title":"Clin Vaccine Immunol"},{"issue":"1","key":"pone.0249259.ref061","first-page":"27","article-title":"Reference ranges and sources of variability of CD4 counts in HIV-seronegative women and men.","volume":"72","author":"MK Maini","year":"1996","journal-title":"Genitourin Med"},{"issue":"4","key":"pone.0249259.ref062","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/2325957414530472","article-title":"HIV Clinical Management Normal CD4 Count Range among Healthy Nigerian Population in Ilorin.","volume":"16","author":"JK Afolabi","year":"2017","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"pone.0249259.ref063","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2147\/OAJCT.S77316","article-title":"Conducting clinical trials in emerging markets of sub-Saharan Africa: review of guidelines and resources for foreign sponsors.","volume":"7","author":"G Puppalwar","year":"2015","journal-title":"Open Access J Clin Trials"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T04:38:44Z","timestamp":1724733524000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249259"}},"subtitle":[],"editor":[{"given":"Colin","family":"Johnson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":63,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0249259","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]}}}