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Malaria infecton is not an uncommon parasitic disease in humans affecting 103 countries worldwide [1]. South-East Asian countries like India, Myanmar and Indonesia account for approximately 94% of the reported malaria cases, with India carrying a high burden of the disease, still reporting 65% of the cases [2]. Clinical diagnoses of malarial infection from other tropical infections, based on patients’ signs and symptoms or physicians’ findings, may be difficult [3]. Definitive diagnosis is essential for the management and control of malaria. It has been shown that traditional methods for diagnosing malaria remain problematic with many limitations [4]. The detection of malaria by light microscopy of stained smears has remained the gold standard. Many haematological abnormalities are associated with malaria, however, none of these abnormalities are specific [5]. P. falciparum as well as P. vivax is known to cause significant hematological changes with high occurrence of thrombocytopenia, anaemia and lymphopenia [6]. The automation in haematology helps in analysing various parameters which helps the pathologist to concentrate more on the peripheral blood smear to search for malarial parasite, thus allow immediate start of specific therapy of the patient [7,8]. Monocytes and lymphocytes are known to get activated by malarial parasites, which are reflected as the heterogeneity of the volume in scattergrams along with infected RBC’s depicted in the nonWBC’s areas of the scattergram called ghost areas. Thus these changes in the volume, conductivity and scatter properties can be easily detected in automated analysers having Volume Conductivity Scatter (VCS) technology. “Suspect malaria” flags can be seen due to abnormal WBC histogram peaks. A flag would be a useful indicator to suspect the presence of malarial parasites which can be used as a routine parameter in the diagnosis of malaria [9]. Platelet indices are altered during acute and symptomatic infection by P. vivax. The elevation of MPV and PDW, and reduction of PCT are related potential risk factors for evolution into severe malaria [10]. Low platelet count (<150×109/L) is an excellent haematological parameter for presumptive diagnosis of malaria. Depolarised Laser Light (DLL) can be helpful in the diagnosis of acute malaria, but cannot replace the existing methods of diagnosis. DLL-based malaria diagnosis is particularly helpful in screening of malaria in situations like screening of blood donors. There is no significant difference in the sensitivity and the specificity of haematological parameters in patients of P. vivax and P. falciparum malaria [1]. Laboratory findings like an abnormal WBC scattergram with thrombocytopenia in a febrile patient help the pathologist to suspect the diagnosis of malaria [2]. WBC/BASO scattergram along with presence of thrombocytopenia are useful in the presumptive diagnosis of P. vivax [11]. Different studies have taken into different parameters to diagnose malaria infection using cell coulters. The present study was conducted to compare multiple parameters like, the WBC scattergram, histogram and platelet indices in normal individuals and those with malaria, so that it can be used as a powerful tool to suspect malaria and search for the same diligently, so that early diagnosis and treatment prevents the complications associated with malaria. BS Ramya1, G PRaShanti2

Role of WBC Scattergram, Histogram and Platelet Indices in Diagnosis of Malaria