Prevalence of neutropenia discovered in routine complete blood cell counts among healthy adults from Saudi Arabia at different altitudes

Abstract

Background: People of African, Middle Eastern, and West Indian descent are disproportionately affected by benign ethnic neutropenia (BEN), one of the most common causes of chronic neutropenia. The prevalence of chronic benign neutropenia among the general population is endemic in Middle Eastern countries.
Objective: The current study aimed to investigate the prevalence of BEN in three different regions of Saudi Arabia and explore the effect of altitudes on it.
Methods: In this retrospective cross-sectional study, the lab reports were collected and screened over two years (September 2020 to August 2022) from the different labs and clinics serving chronic patients located in Jeddah (Sea level), Najran (1293 m above sea level) and Asir (2200 m above the sea level) region. Complete blood count (CBC) reports were analyzed for patients above 12 years from both genders. Exclusion criteria include significant abnormalities in the biochemical and CBC reports. The mean ANC and the prevalence of neutropenia were compared and statistically analyzed by age group and gender amongst three different cities.
Results: A total of 11762, 8534, and 10225 laboratory investigations from the Jeddah, Najran, and Asir regions, respectively, were investigated in this study. The mean ANC for the population from the Jeddah region was 3.37±2.45 x 109/L, while in Najran and Asir regions, it was found to be 3.01±1.54 x 109/L and 2.86±1.44 x 109/L respectively. Laboratory findings of isolated neutropenia were frequent, with a prevalence ranging from 19.64% to 35.2%.
Conclusion: People living in various regions of Saudi Arabia frequently have mild to moderate neutropenia. Furthermore, isolated neutropenia is more prevalent among people living at high altitudes. Environmental and altitude factors and underlying ethnic neutropenia are likely to be key contributors to this high frequency.