title: Use of Sysmex XE-2100 and XE-5000 hematology analyzers for the diagnosis of malaria in a nonendemic country (France).
abstract: BACKGROUND
  Most studies dealing with automated hematology analyzers (HAs) and malaria diagnosis are conducted in endemic countries.
  
  
  METHODS
  We retrospectively studied cell blood counts (CBCs) performed with Sysmex XE-2100 and XE-5000 HAs in our center (Angers, France) regarding 67 patients returning from endemic areas and infected with various Plasmodium species.
  
  
  RESULTS
  In 83% of infected samples with Plasmodium vivax (Pv), ovale (Po), or malariae (Pm), extra clouds of dots were present in neutrophil and/or eosinophil area(s) on routine differential (DIFF) scattergrams. In contrast, samples infected with Plasmodium falciparum (Pf) failed to show such DIFF scattergrams, or any other suggesting malaria infection (0/ 49 pts). Abnormal areas from DIFF scattergrams were related to the presence of mature schizonts and gametocytes, undestroyed by lysis agent, the latter not observed in Pf-infected patients from our series. The internal parameter WBC[DIFF] - WBC[BASO] raised in parallel to parasitemia in Pv, Po, and Pm samples but could not be used as a surrogate for parasitemia. In Pf infection, reticulocyte/ immature reticulocyte fraction (IRF) ratio showed a significant correlation with parasitemia (P < 0.05). A diagnostic model developed for Pf in endemic countries showed sensitivity of 77%.
  
  
  CONCLUSIONS
  Using SYSMEX analyzers, Pv, Po, and Pm infections are easy to ascertain as DIFF scattergrams are almost specific (specificity = 99.9%). Pf infection diagnosis by CBC may be a more promising tool.
authors.affiliation: Laboratory of Hematology, Biology Institute in Health, University Hospital of Angers, Angers, France.
authors.forename: P
authors.initials: P
authors.lastname: Dubreuil
authors.forename: M
authors.initials: M
authors.lastname: Pihet
authors.forename: S
authors.initials: S
authors.lastname: Cau
authors.forename: S
authors.initials: S
authors.lastname: Croquefer
authors.forename: P A
authors.initials: PA
authors.lastname: Deguigne
authors.forename: A
authors.initials: A
authors.lastname: Godon
authors.forename: F
authors.initials: F
authors.lastname: Genevieve
authors.forename: L
authors.initials: L
authors.lastname: De Gentile
authors.forename: M
authors.initials: M
authors.lastname: Zandecki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D005260:Female; D005602:France; D016701:Guinea; D006403:Hematologic Tests / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008288:Malaria / Q000097:blood* / Q000175:diagnosis* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010961:Plasmodium / Q000145:classification / Q000254:growth & development; D010963:Plasmodium falciparum; D010976:Platelet Count; D015203:Reproducibility of Results; D017701:Reticulocyte Count; D014195:Travel; D055815:Young Adult
keywords: Malaria; Sysmex XE-2100; Sysmex XE-5000; cell blood count; hematology analyzers