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Use of Sysmex XE ‐2100 and XE ‐5000 hematology analyzers for the diagnosis of malaria in a nonendemic country (France)
Author(s) -
Dubreuil P.,
Pihet M.,
Cau S.,
Croquefer S.,
Deguigne P. A.,
Godon A.,
Genevieve F.,
Gentile L.,
Zandecki M.
Publication year - 2014
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12145
Subject(s) - hematology analyzer , medicine , chemistry
Summary Introduction Most studies dealing with automated hematology analyzers (HAs) and malaria diagnosis are conducted in endemic countries. Methods We retrospectively studied cell blood counts ( CBC s) performed with Sysmex XE ‐2100 and XE ‐5000 HAs in our center (Angers, France) regarding 67 patients returning from endemic areas and infected with various Plasmodium species. Results In 83% of infected samples with Plasmodium vivax ( Pv ), ovale ( Po ), or malariae ( Pm ), extra clouds of dots were present in neutrophil and/or eosinophil area(s) on routine differential ( DIFF ) scattergrams. In contrast, samples infected with Plasmodium falciparum ( Pf ) failed to show such DIFF scattergrams, or any other suggesting malaria infection (0/ 49 pts). Abnormal areas from DIFF scattergrams were related to the presence of mature schizonts and gametocytes, undestroyed by lysis agent, the latter not observed in Pf‐ infected patients from our series. The internal parameter WBC [ DIFF ] − WBC [ BASO ] raised in parallel to parasitemia in Pv , Po , and Pm samples but could not be used as a surrogate for parasitemia. In Pf infection, reticulocyte/ immature reticulocyte fraction ( IRF ) ratio showed a significant correlation with parasitemia ( P < 0.05). A diagnostic model developed for Pf in endemic countries showed sensitivity of 77%. Conclusion Using SYSMEX analyzers, Pv , Po , and Pm infections are easy to ascertain as DIFF scattergrams are almost specific (specificity = 99.9%). Pf infection diagnosis by CBC may be a more promising tool.