Detection of Imported Malaria with the Cell-Dyn 4000 Hematology Analyzer

Abstract

The sensitivity and specificity of the Cell-Dyn 4000 hematology analyzer in the diagnosis of imported malaria were studied with samples from patients in an academic hospital setting. The performance of the Cell-Dyn 4000 hematology analyzer was compared with that of conventional diagnostic methods for malaria. The Cell-Dyn 4000 hematology analyzer detected hemozoin-containing depolarizing monocytes in 29 of 58 patients with malaria and 2 of 55 patients without malaria. The presence or absence of depolarizing monocytes in patients with malaria was related to duration of symptoms before presentation for malaria analysis. A second parameter, pseudoreticulocytosis due to nuclear material of intraerythrocytic malaria parasites, was detected by the Cell-Dyn 4000 hematology analyzer almost exclusively in Plasmodium falciparum malaria patients with parasitemia levels of >0.5%. Attention to these abnormalities in medical centers without tropical disease expertise may decrease a delay in the diagnosis of malaria.

Automated Detection of Malaria-Associated Pseudoeosinophilia and Abnormal WBC Scattergram by the Sysmex XE-2100 Hematology Analyzer: A Clinical Study with 1,801 Patients and Real-Time Quantitative PCR Analysis in Vivax Malaria-Endemic Area

“…7,8 Furthermore, because hemozoin in WBC seems to be a sensitive indicator of prognosis, an automated hematology analyzer may offer a new way to assess disease severity. 3 In this study, the mean difference in eosinophil counts between the Sysmex XE-2100 analyzer and microscopic examination was 16.0%, and the mean difference in neutrophil counts was 12.9%. This difference could be explained by the incorrect classification of hemozoin-containing neutrophils as eosinophils in malaria patients.…”

“…Most reports are studies regarding abnormal depolarizing patterns of the Cell-Dyn hematology analyzer (Abbott Diagnostics, Santa Clara , CA). [1][2][3][4][5][6] Recent studies from South Korea investigated pseudoeosinophilia and abnormal white blood cell (WBC) scattergrams of vivax malaria-infected patients on a Sysmex XE-2100 hematology analyzer (Sysmex Corporation, Kobe, Japan). 7,8 Because the sensitivity and specificity of these methods were apparently high, its application to early detection can lead to a significant reduction in patients' morbidity and mortality.…”

ASSOCIATION BETWEEN ATYPICAL DEPOLARIZATION IN CELLDYN 00 AND THE PRESENCE OF PLASMODIUM SPP IN BLOOD IN Dr. SOETOMO HOSPITAL SURABAYA

“…Recent studies using automated hematology analyzers have demonstrated unexpected abnormalities in differential white blood cell plots and reticulocyte histograms from patients with malaria. 6 In normal blood samples, the only depolarizing WBC events are eosinophils. With Cell-Dyn multiangle polarized scatter separation (MAPSS) analysis, normal eosinophils viewed in the polarized-90° versus depolarized-90° (NEU EOS) plot form a distinct cloud of events that are color coded green.…”

Detection of Intracellular Parasites by Use of the CellaVision DM96 Analyzer during Routine Screening of Peripheral Blood Smears

“…One disadvantage of RDTs is that microscopy is needed to estimate the percent parasitemia and verify the species. There has been an increase in the number of automated hematology analyzers used for detection of malaria (13)(14)(15)(16)(17)(18) by flow cytometry methods. The sensitivity has ranged from 48 to 95% compared to microscopy.…”

“…The reported sensitivity of microscopy ranges from 85% to 93% (7,8), with experienced microscopists being able to detect Ͻ100 to 500 parasites/l (7, 9). There have been diagnostic advances for malaria, including PCR (10), rapid diagnostic tests (RDTs) (11,12), and automated hematology analyzers (13)(14)(15)(16)(17)(18). PCR has a higher sensitivity than microscopy (100% versus 93%, respectively), with the ability to detect less than 5 parasites/l (8).…”