SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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EE Escher 1 , CF Fuchs-Meier 2 , LH Hürzeler2 , JM Muser2 , HP.M Marti1 , BB Beck1 , CH Hatz1

1 Swiss Tropical Institut, Socinstrasse 57, 4051 Basel, 2 University Teaching Hospital, 4410 Liestal

Background: Haemozoin – an insoluble microcrystaline substance, which is produced by Plasmodium spp. as a non-toxic end product of hemoglobin digestion - is able to depolarize light, allowing its automated detection in routine analysis of complete blood counts using special Abbott Cell-Dyn instruments. In prospective blinded study, we evaluated the Cell-Dyn CD 4000 comparing its results with diagnostic gold standard microscopy.

Material and methods: 99 EDTA-anticoagulated samples submitted for malaria investigation were examined by thick and thin film microscopy for parasite detection, species identification and determination of the percentage of malaria parasitaemia. All samples were analysed with the CD-4000 device in normal WBC operational mode.

Results: 99 blood samples were comperatively tested, performing microscopy vs. CD 4000 results. 50 patients showed positive malaria results on microscopy, 49 samples were negative. Of those, CD 4000 patterns compatible with malaria were observed in 41/50 positive and in 17/49 negative samples.

Conclusion: Considering the specificity and positive predictive value of 74 % and 75 %, the outcome appears to be disappointing in comparison with the microscopical results of an experienced laboratory technician. However, the routinely performed CD 4000 results may contribute to diagnose malaria among patients in whom the disease may not have been considered.


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