Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Biomed Res Int. 2024 Apr 20;2024:6963423. doi: 10.1155/2024/6963423. eCollection 2024.
An accurate urine analysis is a good indicator of the status of the renal and genitourinary system. However, limited studies have been done on comparing the diagnostic performance of the fully automated analyser and manual urinalysis especially in Ghana. This study evaluated the concordance of results of the fully automated urine analyser (Sysmex UN series) and the manual method urinalysis at the Komfo Anokye Teaching Hospital in Kumasi, Ghana. . Sixty-seven (67) freshly voided urine samples were analysed by the automated urine analyser Sysmex UN series and by manual examination at Komfo Anokye Teaching Hospital, Ghana. Kappa and Bland-Altman plot analyses were used to evaluate the degree of concordance and correlation of both methods, respectively.
Substantial ( = 0.711, < 0.01), slight ( = 0.193, = 0.004), and slight ( = 0.109, < 0.001) agreements were found for urine colour, appearance, and pH, respectively, between the manual and automated methods. A strong and significant correlation ( = 0.593, < 0.001) was found between both methods for specific gravity with a strong positive linear correlation observed for red blood cell count ( = 0.951, = 0.904, < 0.001), white blood cell count ( = 0.907, = 0.822, < 0.001), and epithelial cell count ( = 0.729, = 0.532, < 0.001). A perfect agreement of urine chemistry results in both methods was observed for nitrite 67 (100%) ( = 1.000, < 0.001) with a fair agreement for protein 46 (68.7%) ( = 0.395, < 0.001). A strong agreement was found in both methods for the presence of cast 65 (97.0%) ( = 0.734, < 0.001) with no concordance observed for the presence of crystals ( = 0.115, = 0.326) and yeast-like cells (YLC) ( = 0.171, = 0.116).
The automated and manual methods showed similar performances and good correlation, especially for physical and chemical examination. However, manual microscopy remains necessary to classify urine sediments, particularly for bacteria and yeast-like cells. Future research with larger samples could help validate automated urinalysis for wider clinical use and identify areas requiring improved automated detection capabilities.
准确的尿液分析是评估肾脏和泌尿生殖系统状况的良好指标。然而，在加纳等国家，关于全自动分析仪与手动尿液分析的诊断性能比较的研究还很有限。本研究评估了全自动尿液分析仪（Sysmex UN 系列）与加纳库马西 Komfo Anokye 教学医院的手动尿液分析方法的结果一致性。对 67 例新鲜排空的尿液样本进行了分析，使用了 Sysmex UN 系列的自动尿液分析仪和手动检查。Kappa 和 Bland-Altman 图分析分别用于评估两种方法的一致性和相关性程度。
手动和自动方法之间在尿液颜色、外观和 pH 值方面分别显示出显著（ = 0.711， < 0.01）、轻微（ = 0.193， = 0.004）和轻微（ = 0.109， < 0.001）的一致性。两种方法之间在比重方面存在强烈且显著的相关性（ = 0.593， < 0.001），并且观察到红细胞计数（ = 0.951， = 0.904， < 0.001）、白细胞计数（ = 0.907， = 0.822， < 0.001）和上皮细胞计数（ = 0.729， = 0.532， < 0.001）之间存在强烈的正线性相关性。两种方法在尿液化学结果方面表现出完美的一致性，亚硝酸盐为 67 例（100%）（ = 1.000， < 0.001），而蛋白质为 46 例（68.7%）（ = 0.395， < 0.001）表现出良好的一致性。两种方法在存在铸型方面均表现出强烈的一致性，65 例（97.0%）（ = 0.734， < 0.001），而在存在晶体（ = 0.115， = 0.326）和酵母样细胞（YLC）（ = 0.171， = 0.116）方面没有一致性。
自动和手动方法表现出相似的性能和良好的相关性，特别是在物理和化学检查方面。然而，手动显微镜仍然是必要的，以对尿液沉淀物进行分类，特别是对细菌和酵母样细胞。未来的研究如果能增加样本量，将有助于验证自动化尿液分析在更广泛的临床应用中的有效性，并确定需要改进自动化检测能力的领域。
