Blood Smear Test Research Articles

Challenges of Severe Malaria Management in Patient Returning from Jayapura, Indonesia Presented with Severe Anemia: A Case Report

We report a 55-year-old woman who presented to the hospital with intermittent fever for a month. The patient had a history of living in a malaria endemic area (Jayapura, Papua Province, Indonesia) for approximately 15 years. The hemoglobin level was very low (4.2 mg/dL). Furthermore, we conducted a follow-up supporting examination, Malaria Rapid Diagnostic Test (RDT), the result was positive for malaria tropica (Plasmodium falciparum). Blood smear test was also carried out to confirm the diagnosis, the result was that immature trophozoites (ring shape) were found. Thus, the patient was diagnosed with severe malaria tropica with clinical manifestations indicative of severe anemia. The patient was treated for 3 days with anti-malarial drugs and supportive drugs according to the symptoms in the hospital and was advised to follow up 7 days later. This case report describe the challenges of severe malaria management in patient returning from Jayapura with severe anemia.

Impact of the Introduction of Artesunate on the Management of Severe Malaria in Casamance (Senegal): A Comparative Analysis of Data From 2016 and 2020

Background: the implementation of different control strategies, including the treatment of severe forms with injectable artesunate, has made it possible to significantly reduce malaria in Senegal. Despite everything, malaria remains a concern in Senegal, especially in the southern regions, hence the interest in studying these characteristics and their evolution over time. Objectives: describe the epidemiological, clinical and evolving aspects of severe malaria before and after implementation of artesunate treatment. Patients and methods: retrospective, cross-sectional, descriptive and analytical study focusing on cases of severe malaria admitted in two health structures in the Vélingara district in 2016 and 2020. The severity of diagnosis was made based on the current criteria of the WHO and confirmation made by thick blood smear and/or HRP2 rapid diagnostic test. The data was entered into Excel and analyzed with Epi-info version 7.2.6. Results: In 2016, 357 cases of serious malaria were recorded from January 1st to December 31st, with 75.6% in October and December. The average age is 16.2 ± 12.9 years, with a predominance of the age group 6-15 years (38,94%). There was a male predominance and the sex ratio was 1.01. Coma (57%), convulsions (34%) and jaundice (14%) were the most common signs of severity. Under treatment with quinine salts (97%) and artemether (3%), the lethality was 5%. Factors significantly associated with death were rural origin (p:0.009), coma (p:0.000), hepatomegaly (p:0.03) and diffuse hemorrhages (p:0.03). In 2020, 456 cases were collected from July 1st to December 31st, with 75.44% in October and November. The average age was 15.38±15.36 years (1 to 85 years) with a predominance of age group 6 to 15 years (46.49%). There was a male predominance and the sex ratio was 1.06. The signs of severity were dominated by prostration (52.63%), repeated convulsions (17.11%), coma (7.9%) and jaundice (7.2%). All patients were treated with injectable artesunate with a lethality of 3.5%. Death was significantly associated with coma (p:0.000) and the occurrence of respiratory failure (p:0.000). Conclusion: severe malaria remained a childhood pathology with neurological manifestations predominating in Vellingara. A drop in lethality is observed with the generalization of artesunate-based treatment.

Nodal Low-Grade B-Cell Lymphoma Co-Expressing CD5 and CD10 but Not CD23, IRTA1, or Cyclin D1: The Diagnostic Challenge of a Splenic Marginal Zone Lymphoma.

The diagnosis of lymphoma is based on histopathological and immunophenotypical features. CD5 and CD10 are traditionally considered a T-cell antigen and a germinal center B-cell antigen, respectively. It is very unusual for a low-grade B-cell lymphoma (BCL) to co-express CD5 and CD10. Although the biologic basis or clinical significance of such co-expression is unclear, this rare event may pose a significant diagnostic challenge. Here, we report a case of a 63-year-old male presenting with bilateral cervical lymphadenopathy and lymphocytosis. Histologically, the nodal tumor was largely diffuse with neoplastic small atypical lymphocytes co-expressing CD5, CD10, and CD20, but not CD23 or cyclin D1. The leukemic cells in the peripheral blood exhibited hairy projections. Taking together the marked splenomegaly, involvement of lymph nodes, bone marrow, and peripheral blood, a final diagnosis of splenic marginal zone lymphoma (SMZL) was reached. The patient was alive with partial response for 10 months after immunochemotherapy. The dual expression of CD5 and CD10 is extremely unusual for low-grade BCL and may lead to an erroneous diagnosis. Integrating the findings into peripheral blood smear tests, flow cytometry, histopathology, imaging, and clinical features is mandatory to exclude other lymphoma types and to reach a correct diagnosis, particularly for a case with nodal presentation.

Diagnosis and treatment of Anaplasma centrale in a domestic cat at Animal Hospital of Hasanuddin University Makassar

Anaplasmosis is a disease caused by obligate gram-negative intracellular bacteria. Anaplasma in cats is generally infected by Anaplasma phagocytophilum, however there are very limited reports of Anaplasma bovis such as Anaplasma marginale and Anaplasma centrale being reported to infect cats. This is the first report of anaplasmosis caused by Anaplasma centrale in cats. The owner brought a one-year-old female domestic cat to the Animal Hospital of Hasanuddin University in Makassar with the condition of not wanting to eat, weak, lethargic, dehydrated, and not defaecating. Diagnosis is carried out through anamnesis, physical examination, clinical examination, and laboratory examination, in the form of haematology and blood smear tests. The results of the examination revealed flea infestation, a blood test identified Anaplasma centrale with characteristics such as the presence of morulae in the middle part of the erythrocytes, and routine blood work showed anaemia which was seen in the MCV parameters increasing and the MCHC values decreased. Treatment consists of administration of antibiotics, anti-inflammatory drugs, and supportive therapy. The cat showed good results, with symptoms starting to disappear and the animal appeared active.

Autoimmune hemolytic anemia in a preoperative patient: a case report and literature review

Background: In patients undergoing elective surgery, it is known that as many as one-third have preoperative anemia. Preoperative anemia is associated with an almost five-fold increase in the likelihood of postoperative mortality. So, it is essential to know the cause of anemia so that the management is appropriate so that surgery can be performed safely and prevent patients from dying on the operating table or postoperatively. This case report aims to describe the pathogenesis of the laboratory findings in a patient with autoimmune hemolytic anemia (AIHA) who was accidentally diagnosed during preoperative screening and the management performed. Case: A 65-year-old man with an enlarged prostate was scheduled for elective surgery. Preoperative examination revealed anemic right and left conjunctiva, decreased erythrocytes, hemoglobin, hematocrit, and increased MCV, MCH, and MCHC, peripheral blood smear dominated by red cell agglutination and positive direct Coomb's test. The patient was given methylprednisolone 62.5 mg intravenously before transfusion and given a transfusion of 2 units of slow drip packed red cells (PRC) under close supervision. There were no transfusion reactions during and after transfusion. There was an increase in Hb after transfusion so that the patient could be operated on. Conclusion: The patient in this case was diagnosed with AIHA based on preoperative laboratory findings. Laboratory results showed evidence of autoimmune hemolytic anemia with decreased erythrocytes, hemoglobin, hematocrits, spherocytes, and agglutination on peripheral blood smear and positive Coomb's test. Rapid identification and treatment of anemia help improve preoperative conditions.

A case of equine piroplasmosis in the Tokyo 2020 Olympic Games.

Equine piroplasmosis is an infectious disease caused by Babesia caballi and Theileria equi. A competition horse that had been imported to the Equestrian Park for the Tokyo 2020 Olympic Games and had a fever over 40°C and severe anemia was diagnosed with equine piroplasmosis by blood smear and direct polymerase chain reaction (PCR) tests for Theileria equi. Treatment with protozoan anthelmintics and whole blood transfusion diminished the fever, improved the anemia, and allowed the horse to return home safely. Preparation for routine cases of this infection should include the development of a system that allows accurate and prompt international dissemination of information and implementation of quarantine measures.

Case Report: Diagnosis and Therapy Technique for Dirofilariasis – Ehrlichiosis Coinfection in a Domestic Dog

Multiple pathogenic agents, such as dirofilariasis and ehrlichiosis coinfection in the dog, cause coinfection disease. This paper aims to elucidate the diagnosis and therapy technique of dirofilariasis and ehrlichiosis coinfection disease in a dog. The owner brought a 4-year-old female dog named Lua to Rvet Clinic Tajur Halang Bogor with complaints of always painting when doing activities and lying down. The dog was just adopted one month from the shelter with many ticks and mosquitoes in the cage. The dog was diagnosed with dirofilariasis and ehrlichiosis by physical examination and laboratory tests. The laboratory tests included radiography, haematology, blood smear, and antigen test by SNAP® 4Dx® Plus Test (IDEXX, US). The dog was given doxycycline 10 mg/kg BW BID orally for three weeks, vitamin B12 0.025mg/kg BW BID orally for three weeks, furosemide 2 mg/kg BW SID orally for one week, Coenzyme-Q10 SID orally for three weeks, and selamectin topical drop every month for three months. A blood smear on the 21st day after therapy did not show microfilariae in 20 hpf with three repetitions. It means the therapy combinations are used effectively to reduce microfilariae and maintain the clinical sign of a dog due to dirofilariasis accompanied by ehrlichiosis.

Study of Canine Babesiosis in Pet and Stray Dogs of Kathmandu Valley

Canine babesiosis is caused by protozoan parasites which is usually transmitted via various species of ticks. The parasites ultimately parasitize the erythrocytes of host body, resulting in fever, anemia, and hemoglobinuria. From June 2021 to September 2021, a cross-sectional study using the purposive sampling method was conducted. A total of 140 samples were collected from dogs and were examined for the presence of Babesia spp. using thin blood smear test stained in Giemsa. Regression analysis was done to compare categorical and outcome variables. The overall prevalence of babesiosis was found to be 14.3%. The result showed significantly higher prevalence of babesiosis in tick infected dogs (p<0.05). Sex, age, type and breed wise prevalence were found to be statistically insignificant (p>0.05). In hematological parameters, RBC, Hb, PCV, and platelets declined significantly in positive cases (p<0.05). In TLC, the changes in the Babesia positive cases were statistically insignificant (p>0.05), whereas in DLC of the infected cases, changes only in neutrophils and lymphocytes were statistically significant (p<0.05). The mean temperature in positive cases was found to be 103.44±0.69. This research intends to add some information on the status of babesiosis inside Kathmandu valley with majorly concluding ticks as major cause of diseases. Tick control is therefore critical in order to reduce the prevalence.

Imported diseases in travellers presenting to the emergency department after a stay in a malaria-endemic country: a retrospective observational study

BackgroundWe aimed to investigate the aetiology and outcomes of illnesses in patients presenting to an emergency department after travelling to a malaria-endemic country, in order to raise awareness of both tropical and cosmopolitan diseases.MethodsA retrospective chart review was performed for all patients who underwent blood smear testing for malaria at the Emergency Department of the University Hospitals Leuven from 2017 to 2020. Patient characteristics, results of laboratory and radiological examinations, diagnoses, disease course and outcome were collected and analysed.ResultsA total of 253 patients were included in the study. The majority of ill travellers returned from Sub-Saharan Africa (68.4%) and Southeast Asia (19.4%). Their diagnoses fell into three major syndrome categories: systemic febrile illness (30.8%), inflammatory syndrome of unknown origin (23.3%) and acute diarrhoea (18.2%). Malaria (15.8%) was the most common specific diagnosis in patients with systemic febrile illness, followed by influenza (5.1%), rickettsiosis (3.2%), dengue (1.6%), enteric fever (0.8%), chikungunya (0.8%) and leptospirosis (0.8%). The presence of hyperbilirubinemia and thrombocytopenia increased the probability of malaria, with a likelihood ratio of 4.01 and 6.03, respectively. Seven patients (2.8%) were treated in the intensive care unit, and none died.ConclusionSystemic febrile illness, inflammatory syndrome of unknown origin and acute diarrhoea were the three major syndromic categories in returning travellers presenting to our emergency department after a stay in a malaria-endemic country. Malaria was the most common specific diagnosis in patients with systemic febrile illness. None of the patients died.

Five Years’ Experience with Gene Panel Sequencing in Hereditary Hemolytic Anemia Screened by Routine Peripheral Blood Smear Examination

Hereditary hemolytic anemia (HHA) is defined as a group of heterogeneous and rare diseases caused by defects of red blood cell (RBC) metabolism and RBC membrane, which leads to lysis or premature clearance. The aim of this study was to investigate individuals with HHA for potential disease-causing variants in 33 genes reported to be associated with HHA. A total of 14 independent individuals or families diagnosed with suspected HHA, and in particular, RBC membranopathy, RBC enzymopathy, and hemoglobinopathy, were collected after routine peripheral blood smear testing. A custom designed panel, including the 33 genes, was performed using gene panel sequencing on the Ion Torrent PGM™ Dx System. The best candidate disease-causing variants were confirmed by Sanger sequencing. Several variants of the HHA-associated genes were detected in 10 out of 14 suspected HHA individuals. After excluding those variants predicted to be benign, 10 pathogenic variants and 1 variant of uncertain significance (VUS) were confirmed in 10 individuals with suspected HHA. Of these variants, the p.Trp704Ter nonsense variant of EPB41 and missense p.Gly151Asp variant of SPTA1 were identified in two out of four hereditary elliptocytoses. The frameshift p.Leu884GlyfsTer27 variant of ANK1, nonsense p.Trp652Ter variant of the SPTB, and missense p.Arg490Trp variant of PKLR were detected in all four hereditary spherocytosis cases. Missense p.Glu27Lys, nonsense p.Lys18Ter variants, and splicing errors such as c.92 + 1G > T and c.315 + 1G > A within HBB were identified in four beta thalassemia cases. This study provides a snapshot of the genetic alterations in a cohort of Korean HHA individuals and demonstrates the clinical utility of using gene panels in HHA. Genetic results can provide precise clinical diagnosis and guidance regarding medical treatment and management for some individuals.

Prolonged Fever in a Child With Congenital Heart Disease and a Prosthetic Valve.

Prolonged Fever in a Child With Congenital Heart Disease and a Prosthetic Valve.

Differential diagnosis of theileriosis through blood smear examination and polymerase chain reaction in small ruminants from Pakistan.

Ovine and caprine theileriosis is a tick-borne hemoprotozoan disease, caused by Theileria spp., responsible for heavy economic losses in terms of high mortality and morbidity rates. Diagnosis of ovine theileriosis is primarily based on clinical symptoms, microscopic screening of stained blood smears, and lymph node biopsy smears, but the limitations of these detection methods against Theileria spp. infection limits their specificity. To overcome these limitations, the current study reports the differential diagnosis of theileriosis through a blood smear examination and polymerase chain reaction (PCR) in small ruminants from Pakistan. The study was conducted on 1,200 apparently healthy small ruminants (737 sheep and 463 goats). First, blood smears were screened for the presence of Theileria piroplasms in red blood cells. Second, PCR amplification based on 18S rRNA gene was performed by using primers specific to Theileria spp. Out of the 1,200 samples of examined blood smears, 100 animals (8.33%) were found positive for Theileria species, which showed intra-erythrocytic bodies in the form of dot and comma shapes. Amplification of the isolated DNA from randomly collected blood samples of 737 sheep and 463 goats showed that an amplicon size of 1,098 bp was positive for Theileria spp. In total, 315 out of the 1,200 small ruminants examined in this study were found positive for Theileria spp. DNA through PCR amplification. Notably, out of the 885 blood samples negative by PCR amplification, only 15 blood samples were found positive by the blood smear test. Conversely, 230 blood samples that tested negative in the smear technique produced a specific band through PCR amplification. Overall, the sensitivity and specificity rates were 26.98% and 98.31% for the blood smear method and 73.01% and 100% for the PCR assay, respectively. Our finding suggests that PCR is the gold standard method compared to the conventional method of smear examination for the diagnosis of ovine and caprine theileriosis in Pakistan.

Hydroxyurea treatment is associated with lower malaria incidence in children with sickle cell anemia in sub-Saharan Africa

AbstractRealizing Effectiveness Across Continents with Hydroxyurea (REACH, NCT01966731) provides hydroxyurea at maximum tolerated dose (MTD) for children with sickle cell anemia (SCA) in sub-Saharan Africa. Beyond reducing SCA-related clinical events, documented treatment benefits include ∼50% reduction in malaria incidence. To identify associations and propose mechanisms by which hydroxyurea could be associated with lower malaria rates, infections were recorded across all clinical sites (Angola, Democratic Republic of Congo, Kenya, and Uganda). Hazard ratios (HR) with 95% confidence intervals (CIs) for baseline demographics, and time-varying laboratory and clinical parameters were estimated in a modified Cox gap-time model for repeated events. Over 3387 patient-years of hydroxyurea treatment, 717 clinical malaria episodes occurred in 336 of 606 study participants; over half were confirmed by blood smear and/or rapid diagnostic testing with 97.8% Plasmodium falciparum. In univariate analysis limited to 4 confirmed infections per child, malaria risk was significantly associated with absolute neutrophil count (ANC), splenomegaly, hemoglobin, and achieving MTD; age, malaria season, MTD dose, fetal hemoglobin, α-thalassemia, and glucose-6-phosphate dehydrogenase deficiency had no effect. In multivariable regression of confirmed infections, ANC was significant (HR, 1.37 per doubled value; 95% CI, 1.10-1.70; P = .0052), and ANC values <3.0 × 109/L were associated with lower malaria incidence. Compared with nonpalpable spleen, 1- to 4-cm splenomegaly also was associated with higher malaria risk (HR, 2.01; 95% CI, 1.41-2.85; P = .0001). Hydroxyurea at MTD is associated with lower malaria incidence in SCA through incompletely defined mechanisms, but treatment-associated mild myelosuppression with ANC <3.0 × 109/L is salutary. Splenomegaly is an unexplained risk factor for malaria infections among children with SCA in Africa.

Study of Severe Malaria Caused by Plasmodium Vivax in Comparison to Plasmodium Falciparum and Mixed Malarial Infections in Children

Background: Malaria alone is responsible for major proportion of morbidity and mortality in children. Most cases of malaria are due to P.vivax. P.vivax has always been considered benign but recent studies and molecular studies are giving evidences towards increasing virulence and severity of P.vivax Aims and objective: Aim of this study was to observe severe malaria caused by P.vivax in comparison to Falciparum and mixed malarial infections. Other added aim was to observe for concomitant bacterial infections, how it affects clinical outcome and role of antibiotics in such cases of severe malaria. Materials and methods: This was a hospital based study conducted in a tertiary care center in Uttar Pradesh. Patients were tested for malaria using Peripheral blood smear and Rapid malaria antigen test. Total of 200 cases of severe malaria were enrolled in study. Patients were categorized as severe malaria on basis of WHO guidelines. Results: Of 200 cases of severe malaria, 130 (65%) had P.vivax infection, 31 (15.5%) had falciparum infection and 39 (19.5%) had mixed infection with both the species. Noteworthy results observed in cases of severe malaria with P.vivax infections were cerebral malaria (29.2%), severe anemia (26.9 %), severe thrombocytopenia (7.6%) and mortality (13%). Almost 15 % of total patients had concomitant bacterial infections that contributed significantly towards morbidity and prolonged hospitalization. Conclusion: From our study we observed that P.vivax cannot more be considered benign and needs quick diagnosis, prompt treatment and should be observed for complications. Antibiotics use should be considered in severe malaria.

Feasibility and clinical applicability of genomic profiling based on cervical smear samples in patients with endometrial cancer.

PurposeCervical smear samples are easily obtainable and may effectively reflect the tumor microenvironment in gynecological cancers. Therefore, we investigated the feasibility of genomic profiling based on tumor DNA analysis from cervical smear samples from endometrial cancer patients.Materials and methodsPreoperative cervical smear samples were obtained via vaginal sampling in 50 patients, including 39 with endometrial cancer and 11 with benign uterine disease. Matched blood samples were obtained simultaneously. Genomic DNA (gDNA) from cervical smear and/or cell-free DNA from whole blood were extracted and sequenced using the Pan100 panel covering 100 endometrial cancer-related genes.ResultsCervical swab-based gDNA analysis detected cancer with 67% sensitivity and 100% specificity, showing a superior performance compared to that of the matched blood or Pap smear tests. Cervical swab-based gDNA effectively identified patients with loss of MSH2 or MSH6 and aberrant p53 expression based on immunohistochemistry. Genomic landscape analysis of cervical swab-based gDNA identified PTEN, PIK3CA, TP53, and ARID1A as the most frequently altered genes. Furthermore, 26 endometrial cancer patients could be classified according to the Proactive Molecular Risk Classifier for Endometrial Cancer.ConclusionCervical swab-based gDNA test showed an improved detection potential and allowed the classification of patients, which has both predictive and prognostic implications.

Automatic analysis system for abnormal red blood cells in peripheral blood smears.

The type and ratio of abnormal red blood cells (RBCs) in blood can be identified through peripheral blood smear test. Accurate classification is important because the accompanying diseases indicated by abnormal RBCs vary. In clinical practice, this task is time-consuming because the RBCs are manually classified. In addition, because the classification depends on the subjective criteria of pathologists, objective classification is difficult to achieve. In this paper, an automatic classification method that is solely based on images of RBCs captured under a microscope and processed using machine learning (ML) is proposed. The size and hemoglobin abnormalities of RBCs were classified by optimizing the criteria used in clinical practice. For morphologically abnormal RBCs classification, used seven geometric features information (major axis, minor axis, ratio of major and minor axis, perimeter, circularity, number of convex hulls, difference between area and convex area) and five types of multiple classifiers (Support Vector Machine, Decision Tree, K-Nearest Neighbor, Random Forest, and Adaboost models). Among was categorized using SVM, highly accurate results (99.9%) were obtained. The classification is performed simultaneously, and results are provided to the user through a graphical user interface (GUI).

Magnitude of Malaria-Typhoid Fever Coinfection in Febrile Patients at Arba Minch General Hospital in Southern Ethiopia.

Coinfection with malaria and typhoid fever is a major public health issue in developing countries. In endemic areas, including Ethiopia, people are at risk of acquiring both malaria and typhoid fever at the same time. Therefore, this study aimed to determine the magnitude of malaria-typhoid fever coinfection in febrile patients attending hospital at Southern Ethiopia. A hospital-based cross-sectional study was carried out on 416 febrile patients attending Arba Minch General Hospital from 1st October to 30th December 2021. The data was collected using a pretested structured questionnaire. Capillary and Venus blood samples were collected for assessing malaria and typhoid fever, respectively. Blood smear, culture, and biochemical tests were performed based on standard parasitological and microbiological methods. The P-value ≤ 0.05 was considered statistically significant. The magnitude of malaria, typhoid fever, and their coinfections was 26.2% (109/416), 6.5% (27/416), and 3.1% (13/416), respectively. Among the confirmed malaria cases, about 66% of infections were Plasmodium falciparum. The malaria-typhoid fever coinfection showed a statistically significant association with a clinical presentation of a continuous pattern of fever (AOR = 5.84; 95% CI: 1.44-23.71, P = 0.014) and chills (AOR = 3.94; 95% CI: 1.04-14.89, P = 0.044). About 29.6% of Salmonella isolates were multidrug-resistant (MDR). The total rate of coinfection with malaria and typhoid fever was comparable to that of previous studies. With the consideration of higher prevalence of drug resistance of Salmonella spp. and higher prevalence of malaria-typhoid fever coinfection, proper diagnostic procedure should be implemented for proper use of drugs.

Microangiopathic Hemolytic Anemia Associated with Preeclampsia

Introduction: Preeclampsia is the most common hypertensive disease of pregnancy which can be developed during the second half of pregnancy. Among its symptoms, there might be high blood pressure, edema, headache, visual symptoms to name a few. Whereas in laboratory studies it is usually found as data of pre-eclampsia; microangiopathic hemolytic anemia, platelet deficiency and urine protein. Objective: To determine the association of microangiopathic hemolytic anemia with preeclampsia. Material and Methods: Longitudinal, prospective and observational study in patients through laboratory tests such as blood biometry, blood smear and general urine test, and blood pressure measurement, as well as the review of clinical files in order to get the patients’ symptomatology. Results: Among the results, it was found that 63% of the pregnant participants with pre- eclampsia suffered from microangiopathic hemolytic anemia, 54% of them were primiparous and 46% were multiparous. Edema, headache, abdominal pain, transvaginal bleeding and visual issues were the most common symptoms, resulting either in termination of pregnancy or continuity of it with the corresponding hypertensive control. Conclusions: The association between microangiopathic hemolytic anemia and preeclampsia as a complication of pregnancy.

Detection and molecular identification of blood parasites in rodents captured from urban areas of southern Sarawak, Malaysian Borneo.

BackgroundRodent species are well known for their potential as hosts and reservoirs for various zoonotic diseases. Studies on blood parasite infection in small mammals focused on urban cities in Peninsular Malaysia and have been conducted over the years. In contrast, there are information gaps related to molecular detection of blood parasites in urban areas of Sarawak that are associated with veterinary importance and zoonotic spillover potential. Increasing prevalence and transmission of blood parasite diseases is the most crucial public health issue, particularly in developing urban areas of Sarawak. Therefore, molecular identification studies were performed to determine and identify the blood parasites infecting rodents.MethodsA total of 40 rodent blood samples were analysed for blood parasite infection and a combined approach using polymerase chain reaction‐based technique, and traditional microscopic examination (blood smear test) was conducted. 18s rRNA (Plasmodium spp.) and cytochrome b (Hepatocystis spp.) gene marker were used to identify the blood parasites.ResultsNote that 67.5% (n = 27) blood samples were tested negative for blood parasites, while 32.5% (n = 13) blood samples collected were infected with at least one protozoan parasite. Out of 13 samples, 69.2% (n = 9) were detected with Hepatocystis sp., while 15.4% (n = 2) were positive with Hepatozoon ophisauri. Two individuals had multiple infections from both species. No Plasmodium spp. have been detected throughout this study using universal primer (targeted Plasmodium spp.); however, different parasite species which were H. ophisauri were detected.ConclusionAlthough there is no evidence of human infection from H. ophisauri and Hepatocystis sp. detected from the study, the data show the host species are heavily infected, and the information is essential for future prevention of zoonotic outbreaks and surveillance programmes. Therefore, it is suggested that the surveillance programmes should be incorporated in targeted areas with a high risk of disease emergence.

The Relationship between Hemoglobin Levels and Erythrocyte Morphology on the Third Day of Menstruation for Students in The Faculty of Health

Menstruation is the process of releasing the endometrial lining of the uterus due to the release of the hormones estrogen and progesterone, causing bleeding after ovulation from the uterus for approximately fourteen days at regular intervals. The first three days of menstruation is a condition where there is heavy bleeding, so there is iron loss, which can cause a decrease in hemoglobin levels and there is a risk of causing anemia. The occurrence of anemia gives an illustration of morphological changes of erythrocytes. The objective of this study was to determine the relationship between hemoglobin levels and erythrocyte morphology on the third day of menstruation. This type of research is analytic observational with a cross-sectional approach. The sample in this study were 30 students from the Health Faculty of Nahdlatul Ulama University Surabaya who experienced menstruation on the third day. The hemoglobin level was analysed using the Hematology Analyzer Xp-300 method. A blood smear test with Giemsa stain were used for abnormalities erythrocytes morphology observation. The results of the statistical analysis used the chi-square test showed there was no relationship between hemoglobin levels and erythrocyte size (p-value = 0.836), erythrocyte shape (p-value = 0.416). However, there was a relationship between hemoglobin levels and erythrocyte colour (p&lt;0.05). Based on the study result, it can be concluded that there is no relationship between hemoglobin levels and erythrocyte morphology on the third day of menstruation.