Evaluation of automated hematology analyser: Mindray BC-6800 plus as a screening tool for diagnosing malaria

Background: Malaria is one of the major health problems of developing and tropical countries like India, causing huge financial burden also. Smear examination for diagnosis is a routine and cost-effective method for diagnosis. CBC is one the most commonly ordered test in clinical practice. The Mindray BC-6800 plus haematology analyser provide dedicated flag of “Infected RBC?” for suspected malaria while analysing CBC. Present study attempts to evaluate whether CBC done on BC-6800 plus can serve as an aid for malaria screening and diagnosis.Methods: Prospective study of 30077 cases was carried out where thick and thin smear examination done by experienced microscopists and CBC was analysed on BC- 6800 plus analyser.Results: Total 323 cases were found to be positive for malaria by smear examination, out of which 285 were of P. vivax and 38 were of P. falciparum malaria. Sensitivity of 88.24%, specificity of 99.21%, PPV of 54.70%, NPV of 99.87% for Infected RBC flag for all cases of malaria. For P. vivax malaria cases analyser provided highest sensitivity of 99.65% with NPV of nearly 100%, however P. Falciparum malaria cases analyser produced sensitivity of 2.63% only. In P. vivax cases present study found very good correlation between InR count and parasite load under microscope. Present study also evaluated interference of parasitized red cells in differential count causing falsely elevated neutrophils and/or eosinophils.Conclusions: By lowering threshold for “Infected RBC?” flag to 0, BC-6800 plus can serve as an excellent screening tool especially for P. vivax malaria.

Assessment of blood sample stability for complete blood count using the Sysmex XN-9000 and Mindray BC-6800 analyzers

Background: Different hematological analyzers have different analytical performances that are often reflected in the criteria for sample stability of the complete blood count. This study aimed to assess the stability of several hematological parameters using the XN-9000 Sysmex and BC-6800 Mindray analyzers. Methods: The impact of storage at room temperature and 4 ◦C was evaluated after 2, 4, 6, 8, 24, 36 and 48h using ten normal and 40 abnormal blood samples. The variation from the baseline measurement was evaluated by the Steel­Dwass­Critchlow­Fligner test and by Bland­Altman plots, using quality specifications and critical difference as the total allowable variation. Results: Red blood cells and reticulocyte parameters (i.e. hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, immature reticulocyte fractions, low-fluorescence reticulocytes, middle-fluorescence reticulocytes, high fluorescence mononuclear cells) showed less stability compared to leukocyte and platelet parameters (except for monocyte count and mean platelet volume). The bias for hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width coefficient of variation was higher than the critical difference after 8h using both analyzers. Conclusion: Blood samples measured with both analyzers do not show analytically signifi- cant changes in up to 2h of storage at room temperature and 4 ◦C. However, the maximum time for analysis can be extended for up to 8h when the bias is compared to the critical difference

Evaluation of the Mindray BC-6800 Complete Blood Counts Analyzer

BACKGROUND: The BC-6800 (Mindray, China) is a recently developed hematology analyzer that utilizes 'SF Cube Technology' to improve the reliability of complete blood counts (CBC), white blood cell (WBC) differentials, and erythroblast counts. In this study, we evaluated the performance of the BC-6800 for CBC, WBC differentials, reticulocyte counts, and erythroblast counts and analyzed the efficiency of its flag system. METHODS: Specimens from 100 healthy controls and 95 patients were used. We performed precision and correlation studies of CBC, WBC differentials, reticulocyte counts, and erythroblast counts. We also analyzed the efficiency of the flag system in detecting abnormal blood cells. RESULTS: The coefficients of variation (CVs) of precision were 0.9800 for CBC except erythrocyte indices, and >0.9500 for WBC differentials except monocyte and basophil. The WBC differentials and erythroblast counts obtained using the BC-6800 were well correlated with those of manual counts. The efficiencies of the flag system were 77.9% for Blasts, 82.1% for Immature Gran, 86.3% for Atypical Lymph, and 92.6% for NRBC present. CONCLUSIONS: The BC-6800 showed good precision and correlation with pre-existing hematology analyzers. The flag systems were quite efficient for detecting abnormal blood cells. Our study demonstrated that the BC-6800 hematology analyzer exhibits suitable performance and is helpful in routine laboratories.