title: Sensitive detection and accurate monitoring of Plasmodium vivax parasites on routine complete blood count using automatic blood cell analyzer (DxH800(TM)).
abstract: BACKGROUND
  Plasmodium vivax malaria is one of the most important infectious diseases plaguing humanity and causes significant mortality and morbidity worldwide. The gold standard of P. vivax malaria diagnosis is the microscopy of blood smears. Although microscopy is a rapid, cost-effective, and readily applicable method, it has many disadvantages, including low sensitivity, specificity, and precision. Therefore, there is a clear need for an effective screening test for P. vivax malaria detection both in high-prevalence areas and developed countries.
  
  
  METHODS
  A total of 1761 complete blood count (CBC) samples generated by the automated hematology analyzer (DxH 800™; Beckman Coulter Inc., Miami, FL, USA) were retrospectively analyzed. The sample pool contained 123 samples from 52 P. vivax malaria patients and 1504 nonmalarial samples including 509 patients with leukopenia (white blood cell <2000/μL) and 134 normal subjects.
  
  
  RESULTS
  The P. vivax malaria samples exhibited easily recognizable typical malaria signals on the nucleated red blood cell (nRBC) plots (sensitivity 100%) in DxH 800™. All 1504 samples without P. vivax infection were negative for malaria signal (specificity 100%). The size of P. vivax malaria signals correlated roughly with the parasite burden.
  
  
  CONCLUSIONS
  DxH800™ provides very sensitive and specific, easily recognizable P. vivax malaria signals on routine CBC without need for the additional reagents or special procedures.
authors.affiliation: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: H K
authors.initials: HK
authors.lastname: Lee
authors.forename: S I
authors.initials: SI
authors.lastname: Kim
authors.forename: H
authors.initials: H
authors.lastname: Chae
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Lim
authors.forename: E J
authors.initials: EJ
authors.lastname: Oh
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.forename: Y J
authors.initials: YJ
authors.lastname: Park
authors.forename: W
authors.initials: W
authors.lastname: Lee
authors.forename: K
authors.initials: K
authors.lastname: Han
mesh_terms: D001772:Blood Cell Count / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016780:Malaria, Vivax / Q000175:diagnosis*; D059208:Parasite Load / Q000295:instrumentation / Q000379:methods*; D010966:Plasmodium vivax / Q000302:isolation & purification*; D012680:Sensitivity and Specificity