Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023

Birhanemaskal Malkamu; Getaneh Atikilt Yemata; Andargachew Almaw; Ayenew Assefa; Birhanu Getie; Teklehaimanot Kiros; Mulat Erkihun; Shewaneh Damtie; Tegenaw Tiruneh; Berhanu Abebaw Mekonnen; Meron Asmamaw Alemayehu; Abraham Teym; Abathun Temesgen; Gashaw Melkie Bayeh; Almaw Genet Yeshiwas; Rahel Mulatie Anteneh; Melkamu Aderajew Zemene; Tesfaneh Shimels; Chalachew  Yenew; Wolde Melese Ayele; Ahmed Fentaw Ahmed; Assefa Andargie Kassa; Tilahun Degu Tsega; Chalachew Abiyu Ayalew; Sintayehu Simie Tsega; Zeamanuel Anteneh Yigzaw; Amare Genetu Ejigu; Wondimnew Desalegn Addis; Getasew Yirdaw; Kalaab Esubalew Sharew; Daniel Adane; Samuel Berihun Dagnew; Gebyaw Arega; Habitamu Mekonen

doi:10.1002/jcla.70148

Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023

Birhanemaskal Malkamu^*
, Getaneh Atikilt Yemata
, Andargachew Almaw
, Ayenew Assefa
, Birhanu Getie
, Teklehaimanot Kiros
, Mulat Erkihun
, Shewaneh Damtie
, Tegenaw Tiruneh
, Berhanu Abebaw Mekonnen
, Meron Asmamaw Alemayehu
, Abraham Teym
, Abathun Temesgen
, Gashaw Melkie Bayeh
, Almaw Genet Yeshiwas
, Rahel Mulatie Anteneh
, Melkamu Aderajew Zemene
, Tesfaneh Shimels
, Chalachew Yenew
, Wolde Melese Ayele

Ahmed Fentaw Ahmed, Assefa Andargie Kassa, Tilahun Degu Tsega, Chalachew Abiyu Ayalew, Sintayehu Simie Tsega, Zeamanuel Anteneh Yigzaw, Amare Genetu Ejigu, Wondimnew Desalegn Addis, Getasew Yirdaw, Kalaab Esubalew Sharew, Daniel Adane, Samuel Berihun Dagnew, Gebyaw Arega, Habitamu Mekonen

^*Corresponding author for this work

Jockey Club College of Veterinary Medicine and Life Sciences

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

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Abstract

Background: Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre-analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia.

Methods: This institutionally based cross-sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor's specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random.

Results: Among the 2331 test samples, 829 (35.6%) were clotted, and 269 (11.5%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture.

Conclusion: On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs.

© 2025 The Author(s).

Original language	English
Article number	e70148
Journal	Journal of Clinical Laboratory Analysis
Volume	40
Issue number	2
Online published	27 Dec 2025
DOIs	https://doi.org/10.1002/jcla.70148
Publication status	Published - Jan 2026

Research Keywords

clotting
error
hematology
hemolysis
pre-analytical
RBC

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Malkamu, B., Yemata, G. A., Almaw, A., Assefa, A., Getie, B., Kiros, T., Erkihun, M., Damtie, S., Tiruneh, T., Mekonnen, B. A., Alemayehu, M. A., Teym, A., Temesgen, A., Bayeh, G. M., Yeshiwas, A. G., Anteneh, R. M., Zemene, M. A., Shimels, T., Yenew, C., ... Mekonen, H. (2026). Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023. Journal of Clinical Laboratory Analysis, 40(2), Article e70148. https://doi.org/10.1002/jcla.70148

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abstract = "Background: Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre-analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia. Methods: This institutionally based cross-sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor's specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random. Results: Among the 2331 test samples, 829 (35.6\%) were clotted, and 269 (11.5\%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture. Conclusion: On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs. {\textcopyright} 2025 The Author(s).",

keywords = "clotting, error, hematology, hemolysis, pre-analytical, RBC",

author = "Birhanemaskal Malkamu and Yemata, \{Getaneh Atikilt\} and Andargachew Almaw and Ayenew Assefa and Birhanu Getie and Teklehaimanot Kiros and Mulat Erkihun and Shewaneh Damtie and Tegenaw Tiruneh and Mekonnen, \{Berhanu Abebaw\} and Alemayehu, \{Meron Asmamaw\} and Abraham Teym and Abathun Temesgen and Bayeh, \{Gashaw Melkie\} and Yeshiwas, \{Almaw Genet\} and Anteneh, \{Rahel Mulatie\} and Zemene, \{Melkamu Aderajew\} and Tesfaneh Shimels and Chalachew Yenew and Ayele, \{Wolde Melese\} and Ahmed, \{Ahmed Fentaw\} and Kassa, \{Assefa Andargie\} and Tsega, \{Tilahun Degu\} and Ayalew, \{Chalachew Abiyu\} and Tsega, \{Sintayehu Simie\} and Yigzaw, \{Zeamanuel Anteneh\} and Ejigu, \{Amare Genetu\} and Addis, \{Wondimnew Desalegn\} and Getasew Yirdaw and Sharew, \{Kalaab Esubalew\} and Daniel Adane and Dagnew, \{Samuel Berihun\} and Gebyaw Arega and Habitamu Mekonen",

year = "2026",

month = jan,

doi = "10.1002/jcla.70148",

language = "English",

volume = "40",

journal = "Journal of Clinical Laboratory Analysis",

issn = "0887-8013",

publisher = "Wiley-Liss Inc.",

number = "2",

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Malkamu, B, Yemata, GA, Almaw, A, Assefa, A, Getie, B, Kiros, T, Erkihun, M, Damtie, S, Tiruneh, T, Mekonnen, BA, Alemayehu, MA, Teym, A, Temesgen, A, Bayeh, GM, Yeshiwas, AG, Anteneh, RM, Zemene, MA, Shimels, T, Yenew, C, Ayele, WM, Ahmed, AF, Kassa, AA, Tsega, TD, Ayalew, CA, Tsega, SS, Yigzaw, ZA, Ejigu, AG, Addis, WD, Yirdaw, G, Sharew, KE, Adane, D, Dagnew, SB, Arega, G & Mekonen, H 2026, 'Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023', Journal of Clinical Laboratory Analysis, vol. 40, no. 2, e70148. https://doi.org/10.1002/jcla.70148

Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023. / Malkamu, Birhanemaskal; Yemata, Getaneh Atikilt; Almaw, Andargachew et al.
In: Journal of Clinical Laboratory Analysis, Vol. 40, No. 2, e70148, 01.2026.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

TY - JOUR

T1 - Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia

T2 - A Multicenter Cross-Sectional Study, 2023

AU - Malkamu, Birhanemaskal

AU - Yemata, Getaneh Atikilt

AU - Almaw, Andargachew

AU - Assefa, Ayenew

AU - Getie, Birhanu

AU - Kiros, Teklehaimanot

AU - Erkihun, Mulat

AU - Damtie, Shewaneh

AU - Tiruneh, Tegenaw

AU - Mekonnen, Berhanu Abebaw

AU - Alemayehu, Meron Asmamaw

AU - Teym, Abraham

AU - Temesgen, Abathun

AU - Bayeh, Gashaw Melkie

AU - Yeshiwas, Almaw Genet

AU - Anteneh, Rahel Mulatie

AU - Zemene, Melkamu Aderajew

AU - Shimels, Tesfaneh

AU - Yenew, Chalachew

AU - Ayele, Wolde Melese

AU - Ahmed, Ahmed Fentaw

AU - Kassa, Assefa Andargie

AU - Tsega, Tilahun Degu

AU - Ayalew, Chalachew Abiyu

AU - Tsega, Sintayehu Simie

AU - Yigzaw, Zeamanuel Anteneh

AU - Ejigu, Amare Genetu

AU - Addis, Wondimnew Desalegn

AU - Yirdaw, Getasew

AU - Sharew, Kalaab Esubalew

AU - Adane, Daniel

AU - Dagnew, Samuel Berihun

AU - Arega, Gebyaw

AU - Mekonen, Habitamu

PY - 2026/1

Y1 - 2026/1

N2 - Background: Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre-analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia. Methods: This institutionally based cross-sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor's specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random. Results: Among the 2331 test samples, 829 (35.6%) were clotted, and 269 (11.5%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture. Conclusion: On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs. © 2025 The Author(s).

AB - Background: Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre-analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia. Methods: This institutionally based cross-sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor's specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random. Results: Among the 2331 test samples, 829 (35.6%) were clotted, and 269 (11.5%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture. Conclusion: On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs. © 2025 The Author(s).

KW - clotting

KW - error

KW - hematology

KW - hemolysis

KW - pre-analytical

KW - RBC

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U2 - 10.1002/jcla.70148

DO - 10.1002/jcla.70148

M3 - RGC 21 - Publication in refereed journal

SN - 0887-8013

VL - 40

JO - Journal of Clinical Laboratory Analysis

JF - Journal of Clinical Laboratory Analysis

IS - 2

M1 - e70148

ER -

Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023

Abstract

Research Keywords

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