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Detección automatizada del pigmento de malaria: su viabilidad como diagnóstico de malaria en un área con malaria estacional en el norte de Namibia
Author(s) -
De Langen Adrianus J.,
Van Dillen Jeroen,
Witte Piet de,
Mucheto Samson,
Nagelkerke Nico,
Kager Piet
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01634.x
Subject(s) - malaria , diagnosis of malaria , protozoal disease , geography , environmental health , medicine , plasmodium falciparum , immunology
Summary Objective To evaluate the feasibility of automated malaria detection with the Cell‐Dyn® 3700 (Abbott Diagnostics, Santa Clara, CA, USA) haematology analyser for diagnosing malaria in northern Namibia. Methods From April to June 2003, all patients with a positive blood smear result and a subset of patients with no suspicion of malaria were included. Blood smear and a venous blood sample (to determine haemoglobin, platelet and malaria pigment levels) were collected from each patient. Malaria pigment test characteristics, correlations with blood parameters and pigment clearance time were calculated. Finally, a subset of blood samples was run twice to evaluate the consistency of test outcome. Results Two hundred and eight patients were included. Ninety had a positive blood smear result of which 84 tested positive for malaria pigment and 118 patients had a negative blood smear result of which four tested positive for malaria pigment. Test characteristics as compared with microscopy were as follows: sensitivity 0.93, specificity 0.97, positive predictive value 0.95, negative predictive value 0.95. Rerun of the blood samples resulted in a change of diagnosis in 14%. After 4 weeks, 33% of patients with an initially positive pigment result still tested positive. Malaria pigment was found to be negatively correlated with haemoglobin. Conclusions Automated detection of malaria pigment is a useful diagnostic tool in this semi‐rural area. In low‐risk malaria season, the test can be used for diagnosing malaria because of the high sensitivity. In high‐risk malaria season, the test can be used for excluding malaria in case of a negative pigment result because of the high specificity.