Diagnosis of Malaria Using Automatic Hematology Analyzer / 임상검사와정도관리

ABSTRACT

BACKGROUND: For the diagnosis of malaria, examination of blood smear slides by light microscopy is used as standard, and commercial kits detecting malarial antibodies and antigens are available, and molecular methods such as polymerase chain reaction (PCR) are used additionally. But, these diagnostic methods can be performed when clinicians request them, so problems of misdiagnosing the patients who are not suspected malaria may be occurred. METHODS: In 42 Korean patients with malaria, the author analyzed the characteristic signals of malaria using granularity (90 degrees depolarized) versus lobularity (90 degrees polarized) graph of Cell-Dyn 4000 (CD4000) automatic hematologic analyzer. And, the author examined the presence of malaria in 421 random samples by CD4000 and Giemsa stain. RESULTS: The usefulness of CD4000 in diagnosing malaria are as follows, 93.0% sensitivity, 99.3% specificity, 93.0% positive-predictive value, and 99.3% negative-predictive value. CONCLUSION: CD4000 automatic hematology analyzer has high diagnostic sensitivity and specificity in diagnosing malaria. Because complete blood count (CBC) is the routine test for most patients, this method has advantage of time and cost effectiveness and can even detect malaria in unsuspected cases.