Clinical Chemistry Laboratory, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
Microbiology and Virology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
Int J Lab Hematol. 2018 Jun;40(3):326-334. doi: 10.1111/ijlh.12790. Epub 2018 Feb 21.
Malaria is a life-threatening infectious disease, which has been for long confined to specific endemic areas. Nevertheless, the recent increase in immigration flows from endemic regions and imported cases has reemphasized many diagnostic challenges in Western countries, thus paving the way to introduce rapid and accurate strategies for screening subjects with suspected Malaria infection. Therefore, the aim of this article was to describe our recent experience with Sysmex XN-module for rapid screening of subjects with suspected Malaria.
Fourteen patients admitted to the Emergency Department (Papa Giovanni XXIII Hospital Bergamo, Italy) with a clinical suspicion of Malaria infection were evaluated, along with 1047 control samples. The analysis of peripheral blood was performed with XN-module, and results were then compared to optical microscopy.
Nine patients were positive to Plasmodim falciparum, 3 to Plasmodim vivax, one to Plasmodim ovale, and one to Plasmodim malarie. Characteristic abnormalities could be observed in both white blood cell differential (WDF) and white cell nucleated (WNR) scattergrams (sensitivity 0.64 and specificity 1.0) in 9 samples with parasites at gametocyte or schizos stage irrespective of Plasmodium species and parasitic index, while characteristic scattergram abnormalities could not be seen in the 5 samples containing only parasites at the trophozoites stage. In these cases, specific variations of some cell population data (CPD) could be recorded (sensitivity 1.00 and specificity 0.91).
The peculiar abnormalities observed in CPDs, WDF, and WNR-scattergrams may raise a definite suspicion of Malaria infection. Further studies should then be planned for validating these preliminary findings and assessing whether these specific abnormalities may be incorporated in rapid and inexpensive Malaria diagnostic algorithms.
疟疾是一种危及生命的传染病，长期以来仅限于特定的流行地区。然而，最近来自流行地区的移民流动和输入性病例的增加，再次强调了西方国家在诊断方面面临的许多挑战，从而为筛查疑似疟疾感染的患者引入快速准确的策略铺平了道路。因此，本文旨在描述我们最近使用 Sysmex XN 模块快速筛查疑似疟疾患者的经验。
对 14 名因临床疑似疟疾感染而入住贝加莫 Papa Giovanni XXIII 医院急诊部的患者（意大利），以及 1047 例对照样本进行了评估。XN 模块对外周血进行了分析，然后将结果与光学显微镜进行了比较。
9 例患者对恶性疟原虫呈阳性，3 例对间日疟原虫呈阳性，1 例对卵形疟原虫呈阳性，1 例对恶性疟原虫呈阳性。在寄生虫处于配子体或裂殖体阶段的 9 个样本中，无论疟原虫种类和寄生虫指数如何，白细胞差异（WDF）和白细胞有核（WNR）散点图中都可以观察到特征性的异常（敏感性 0.64，特异性 1.0），而在仅包含滋养体阶段寄生虫的 5 个样本中则无法观察到特征性的散点图异常。在这些情况下，可以记录到一些细胞群体数据（CPD）的特定变化（敏感性 1.00，特异性 0.91）。
CPD、WDF 和 WNR 散点图中观察到的特殊异常可能会引起对疟疾感染的明确怀疑。然后应计划进行进一步的研究，以验证这些初步发现，并评估这些特定异常是否可以纳入快速和廉价的疟疾诊断算法中。
