Flagging Of Malaria Parasite In Hematology Analyzer With Its Correlation On Peripheral Smear And Rapid Diagnostic KIT

ABSTRACT

Background: Malaria has long been known to human populations from across the world. Malaria remains the most important parasitic disease worldwide. Malaria is a potential medical emergency and should be treated accordingly. Routinely malaria is diagnosed using a combination of clinical observations, case history, and diagnostic tests, principally microscopic examination of stained slides. The objective of this study is to detect the flagging of malaria parasite in sysmex with correlation in peripheral smear and kit so that early detection of Malaria can be done with the most accurate result in lesser duration and cost. Objectives:-To detect the flagging of malaria parasite in hematology analyser & to correlate the flagging findings on peripheral smear and rapid diagnostic kit. Methods: the study was conducted in Department of Pathology in collaboration, Teerthankar Mahaveer Medical College and Research Centre (TMMC&RC), Moradabad, Uttar Pradesh. TMMC&RC .A total of 11o cases were enrolled with Patients presenting with fever suggestive of clinical features of malaria (high grade fever with chills) and found serologically positive by blood smear, Sysmex flagging or RDT. Results: On the basis of observations made in the present study, Sysmex flagging was positive in 92 (83.6%) cases, 94 (85.5%) were positive by RDT& PBS positivity was seen in 99 (90%) cases. Among 99 positive cases, 85 were positive for P. vivax, 9 were positive for P. falciparum and 6 were positive for mixed infection. As compared to RDT, Sysmex flagging had 90.4% sensitivity; 56.3% specificity; 92.4% positive predictive value; 50.0% negative predictive value and 84.5% accuracy for detection of malarial parasite. Whereas when compared to PBS, Sysmex flagging had 90.9% sensitivity; 81.8% specificity; 97.8% positive predictive value; 50.0% negative predictive value and 90% accuracy for detection of malarial parasite. Sysmex flagging had moderate and significant agreement with both RDT and PBS assessments. Flagging had a detection rate of 66.7%, 94.1% and 80% respectively for P. falciparum, P. vivax and mixed infections. Conclusion: The findings of present study showed that Sysmex flagging is a cost-effective highly efficacious tool for screening of malaria parasite and it showed a high level of agreement with conventionally used laboratory tests as well as peripheral blood smear.