Abstract
Objective: Malaria is a common parasitic disease present worldwide, especially tropical countries. It is challenging for most laboratories to provide a rapid and accurate diagnosis of malaria by light microscopy when the workload is high. The present study was undertaken to assess the usefulness of automated hematology analyzer Sysmex XN 1000 in the detection of malaria. Methodology: Sysmex XN 1000, a 6 part differential automated hematology analyzer was used to analyze EDTA anticoagulated samples of all febrile cases received from January 2014 to May 2014. Giemsa stained peripheral smears were also examined for malaria parasites. Abnormalities in WBC scattergrams were studied and their alteration in malaria cases recorded. Alterations in hematological parameters and instrument flags for samples positive for parasites were noted. All the samples were subjected to immunochromatographic assay by rapid test devises (RTD). Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by analysis of abnormal WBC scattergrams and by RTDs using immunochromatograpy were calculated. Results: A total of 940 samples were analysed. Out of these, 49 cases were positive for malaria on peripheral smear. Various abnormalities in the WBC scattergrams, hematological parameters of these samples and the instrument flags for these samples were noted. WBC scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26% for malaria diagnosis and RTDs using immunochromatographic assay showed a sensitivity of 90.91% and specificity of 98.92%. Conclusion: Malaria diagnosis by examination of Giemsa stained peripheral smears is still the gold standard for diagnosing malaria, which is a laborious process requiring highly skilled and experienced personnel. Complete blood count is a routine investigation ordered in any febrile case and analysis of scattergrams in such cases can definitely aid in detection of malaria.
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