Abstract
IntroductionThe CellaVision™ DM96 (DM96) is a digital microscopy system which performs well in developed countries. However, to date it has not been evaluated in Africa, where the pathology spectrum encountered is very different. In particular, its utility in a setting with high HIV prevalence has not been assessed, which is of interest because of the morphological aberrations often seen in HIV-positive patients.ObjectivesThis study aimed to evaluate the accuracy of the DM96 in a South African laboratory, with emphasis on its performance in samples collected from HIV-positive patients.MethodsA total of 149 samples submitted for a routine differential white cell count in 2012 and 2013 at the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa were included, of which 79 (53.0%) were collected from HIV-positive patients. Results of DM96 analysis pre- and post-classification were compared with a manual differential white cell count and the impact of HIV infection and other variables of interest were assessed.ResultsPre- and post-classification accuracies were similar to those reported in developed countries. Reclassification was required in 16% of cells, with particularly high misclassification rates for eosinophils (31.7%), blasts (33.7%) and basophils (93.5%). Multivariate analysis revealed a significant relationship between the number of misclassified cells and both the white cell count (p = 0.035) and the presence of malignant cells in the blood (p = 0.049), but not with any other variables analysed, including HIV status.ConclusionThe DM96 exhibited acceptable accuracy in this South African laboratory, which was not impacted by HIV infection. However, as it does not eliminate the need for experienced morphologists, its cost may be unjustifiable in a resource-constrained setting.
Highlights
The CellaVisionTM DM96 (DM96) is a digital microscopy system which performs well in developed countries
Multivariate analysis revealed a significant relationship between the number of misclassified cells and both the white cell count (WCC) and the presence of malignant cells in the blood (Table 4)
We assessed the performance of the DM96 as compared to a manual differential white cell count (DWCC) in 149 samples collected from patients with a wide range of infections and haematological pathologies in a large South African state hospital serving a population with high HIV prevalence
Summary
The CellaVisionTM DM96 (DM96) is a digital microscopy system which performs well in developed countries To date it has not been evaluated in Africa, where the pathology spectrum encountered is very different. With the number of skilled medical technologists on the decline worldwide, morphology skills are becoming ever scarcer, in Africa where laboratory resources are, in general, grossly strained.[2,3] Novis et al reported the smear review rate to be proportional to the number of occupied beds in the hospital served,[4] which they speculated to reflect a higher pathology burden in larger hospitals. In sub-Saharan Africa, the pathology burden (and the need for smear review) is compounded by the HIV epidemic, which places an extra strain on haematology services because of the many haematological complications of HIV infection. There is a dire need for analysers that can improve laboratory efficiency in this setting
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
