Application of Sysmex XN-Series Automated Haematology Analyser in the Rapid Detection of Malaria

Ningombam, Aparna; Sarkar, Abhirup; Acharya, Shreyam; Chopra, Anita; Kumar, Karunesh; Subramanian, Arulselvi

doi:10.1007/s12288-020-01276-x

Cited by 10 publications

(13 citation statements)

References 12 publications

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“…A study conducted in India by Ningombam A et al showed 99.2% parasite detection by abnormal scattergram on similar haematology analyzer used in present study thus showing comparable results. 13 In present study 89 cases were positive for plasmodium vivax, two for falciparum and one was mixed infection. It is in accordance with most of the studies reported plasmodium vivax as the most common infection globally.…”

Section: A H E a D O F P R I N Tsupporting

confidence: 46%

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White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite

Rehan

Khalid²,

Nasreen³

2022

Pak J Med Sci

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Background & Objective: Undiagnosed malarial infectionis associated with significant mortality and morbidity. Laboratory investigations leading to rapid, accurate and timely diagnosis of malaria is still a challenge. This study was done to assess the utility of abnormal White blood cell differential fluorescence (WDF) scattergram for diagnosis of malaria. Our aim was to study the utility of WDF scattergram for early detection of malarial parasite. Methods: All EDTA anti-coagulated blood samples received in laboratory during a period from Dec 2019 to May 2020 were analyzed on anautomated hematology analyzer, Sysmex XN 1000. All abnormal WDF scattergrams pertaining to plasmodium specie were critically evaluated and recorded. Review of Leishman-stained peripheral smears as well as immune-chromatographic assay by rapid test devices (RTD) was done. Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by abnormal scattergram were calculated. Results: Out of total 1, 26,000of samples analyzed, abnormal WDF scattergrams were detected in 96 cases. Amongst these, 95.8% (92) were positive for MP on Leishman-stained peripheral smear as well as on ICT with a p-value of 0.05. WDF scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26%. Positive predictive value of 95.8% whereas negative predictive value of 99.9% was detected. Significant findings of hemolysis, platelet clumps, nucleated RBCS (NRBCs) and RBC agglutination were noted in cases (n=4) with abnormal WDF scattergram negative for malaria on peripheral smear. Conclusion: Interpretation of abnormal WDF scattergram not only increases the early detection rate for malarial parasite but isa strong indicator for presence of hemolysis, RBC agglutination, platelet clumps and leucoerythroblastic blood picture as well. doi: https://doi.org/10.12669/pjms.38.3.4702 How to cite this:Rehan M, Khalid A, Nasreen F. White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4702 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: A H E a D O F P R I N Tsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite

Rehan

Khalid²,

Nasreen³

2022

Pak J Med Sci

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“…There are Authors that plotted gates on haematological software to study haematological malignancies, reactive lymphocytosis and malaria [22], but few studies utilise gating strategies applied in different software as in our case [19] [20]. We think it is possible to adopt gate P1n as a new Q-flag in XN instrumentation to suspect the presence of CD5 positive B clones in lymphocyte counts ≤ 5 × 10 9 /L.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is the interaction of technology useful in laboratory haematology diagnostics?

Falda

Pacioni³

et al. 2022

Preprint

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Background: Monoclonal B lymphocytosis (MBL) increases with age and individuals with high count MBL progress to chronic lymphocytic leukaemia requiring therapy at a rate of ~1%-5% per year. These cases usually have atypical lymphocytes at the microscope, abnormal representation in the scattergram, and positivity of flags. Using XN9000 (Sysmex), we noticed cases of MBL without this correlation. We studied customized gates for discovering MBL cases of our interest. Methods: We considered 212 peripheral blood samples with known phenotypes: 76.7% negative and 23.3% positive for B, T, or NK lymphocytes clones. We created gates studying the XN9000 FCS files in Diva software to identify new areas for better delimiting subpopulations of our interest and calculating sensitivity and specificity. Results: We found significant differences between negative and positive groups for Q-flag "Blasts/Abn Lympho?" (B/AL) and LY-X (p <0.05) with lymphocyte counts below 5×109/L. A new gate P1 normalized by P2 (P1n) differentiated between phenotypes much better than Q-flag B/AL with lymphocyte counts ≤ 5×109/L. Moreover, cases with MBL CD5 positive had higher medians (p <0.05). Conclusion: We propose a gate P1n as a new Q-flag for lymphocytes count ≤ 5×109/L, in order to hypothesize the presence of MBL CD5 positives.

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“…Haematology analysers have been used for at least a decade for malaria diagnosis [ 7 , 11 , 23 , 26 , 29 , 33 ]. The XN-31 is an automated haematology analyser that obtained CE marking in April 2019 to support malaria diagnosis in whole blood samples [ 27 , 35 , 36 , 40 ]. Using fluorescence flow cytometry (FFC) technology, it quantifies malaria-infected red blood cells (MI-RBC) in human blood, i.e., RBCs containing nucleic acids [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of fluorescence flow-cytometry technology using Sysmex XN-31 for imported malaria in a non-endemic setting

et al. 2022

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Malaria diagnosis based on microscopy is impaired by the gradual disappearance of experienced microscopists in non-endemic areas. Aside from the conventional diagnostic methods, fluorescence flow cytometry technology using Sysmex XN-31, an automated haematology analyser, has been registered to support malaria diagnosis. The aim of this prospective, monocentric, non-interventional study was to evaluate the diagnostic accuracy of the XN-31 for the initial diagnosis or follow-up of imported malaria cases compared to the reference malaria tests including microscopy, loop mediated isothermal amplification, and rapid diagnostic tests. Over a one-year period, 357 blood samples were analysed, including 248 negative and 109 positive malaria samples. Compared to microscopy, XN-31 showed sensitivity of 100% (95% CI: 97.13–100) and specificity of 98.39% (95% CI: 95.56–100) for the initial diagnosis of imported malaria cases. Moreover, it provided accurate species identification asfalciparumor non-falciparumand parasitaemia determination in a very short time compared to other methods. We also demonstrated that XN-31 was a reliable method for patient follow-up on days 3, 7, and 28. Malaria diagnosis can be improved in non-endemic areas by the use of dedicated haematology analysers coupled with standard microscopy or other methods in development, such as artificial intelligence for blood slide reading. Given that XN-31 provided an accurate diagnosis in 1 min, it may reduce the time interval before treatment and thus improve the outcome of patient who have malaria.

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Application of Sysmex XN-Series Automated Haematology Analyser in the Rapid Detection of Malaria

Cited by 10 publications

References 12 publications

White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite

White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite

Is the interaction of technology useful in laboratory haematology diagnostics?

Diagnostic accuracy of fluorescence flow-cytometry technology using Sysmex XN-31 for imported malaria in a non-endemic setting

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