Automated haematology analysis to diagnose malaria

Malaria Journal

Review

Germán Campuzano-Zuluaga¹  Martin P Grobusch²  Thomas Hänscheid³ 

[1] Grupo Malaria, Facultad de Medicina, Universidad de Antioquia, Calle 62 #52-59, Lab 610, Medellin, Colombia;Laboratorio Clínico Hematológico, Carrera 43C No. 5-33, Medellín, Colombia;Infectious Diseases, Tropical Medicine and AIDS, Division of Internal Medicine, Academic Medical Centre, University of Amsterdam, PO Box 22660, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Institute of Tropical Medicine, University of Tübingen, Germany;Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Instituto de Microbiologia and Instituto de Medicina Molecular, Faculdade de Medicina, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal;

关键词: Malaria;    Haematology Analyser;    Malaria Diagnosis;    Vivax Infection;    Febrile Patient;   

DOI  :  10.1186/1475-2875-9-346

 received in 2010-09-21, accepted in 2010-11-30,  发布年份 2010

来源: Springer

【 摘 要 】

For more than a decade, flow cytometry-based automated haematology analysers have been studied for malaria diagnosis. Although current haematology analysers are not specifically designed to detect malaria-related abnormalities, most studies have found sensitivities that comply with WHO malaria-diagnostic guidelines, i.e. ≥ 95% in samples with > 100 parasites/μl. Establishing a correct and early malaria diagnosis is a prerequisite for an adequate treatment and to minimizing adverse outcomes. Expert light microscopy remains the 'gold standard' for malaria diagnosis in most clinical settings. However, it requires an explicit request from clinicians and has variable accuracy. Malaria diagnosis with flow cytometry-based haematology analysers could become an important adjuvant diagnostic tool in the routine laboratory work-up of febrile patients in or returning from malaria-endemic regions. Haematology analysers so far studied for malaria diagnosis are the Cell-Dyn®, Coulter® GEN· S and LH 750, and the Sysmex XE-2100® analysers. For Cell-Dyn analysers, abnormal depolarization events mainly in the lobularity/granularity and other scatter-plots, and various reticulocyte abnormalities have shown overall sensitivities and specificities of 49% to 97% and 61% to 100%, respectively. For the Coulter analysers, a 'malaria factor' using the monocyte and lymphocyte size standard deviations obtained by impedance detection has shown overall sensitivities and specificities of 82% to 98% and 72% to 94%, respectively. For the XE-2100, abnormal patterns in the DIFF, WBC/BASO, and RET-EXT scatter-plots, and pseudoeosinophilia and other abnormal haematological variables have been described, and multivariate diagnostic models have been designed with overall sensitivities and specificities of 86% to 97% and 81% to 98%, respectively. The accuracy for malaria diagnosis may vary according to species, parasite load, immunity and clinical context where the method is applied. Future developments in new haematology analysers such as considerably simplified, robust and inexpensive devices for malaria detection fitted with an automatically generated alert could improve the detection capacity of these instruments and potentially expand their clinical utility in malaria diagnosis.

【 授权许可】

Unknown   
© Campuzano-Zuluaga et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.