diagnostico de malaria mediante analizadores hematologicos automatizados

8/11/2019 Diagnostico de Malaria Mediante Analizadores Hematologicos Automatizados

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Lic. TM Congona Rivera Roberts Yuri

Dcte. UNMSM UAP - TM AngloLab


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Thickfilm, the standard diagnostic procedure for malaria, isnot always orderedpromptly

Automated haematology analysis to diagnose malaria. Campuzano-Zuluaga et al. Malaria Journal 2010


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In endemic regions, malaria is a prime diagnostic concern in febrile

patients, and expert thickfilm evaluationis usually available.


Recurrent fever and influenza-like symptoms after a stay in tropical regions suggest malaria.


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Expert film evaluation

basophilic stippling


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However, the accuracy of microscopic malaria diagnosis in less

experiencedcenters or in non-endemic regions may be lower,

leading to delayed diagnoses.

Automated full blood counts (FBC) are usually performed in patients with febrile illnesses, providing

a unique opportunity to guide a timely parasitological malaria diagnosis.



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The interest in haematology analysers was renewed after afirst

report showing that a Cell-Dynanalyser allowed for a rather

specific detection of malaria pigment in leukocytes . This

discovery led to a series of,which have confirmed the potential of

these instruments to aid in the diagnosis of malaria



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SENSIBILIDAD

Capacidad de la prueba para identificar correctamente a los individuos quetienen malaria

ESPECIFICIDAD

Capacidad de la prueba para identificar correctamente a los individuos que no malaria


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The Sysmex XE-2100 automated haematology analyser uses combined :

32 clinical variables

Graphs seven scatter-plots :

Three scatter-plots have shown significant abnormalities in

samples with malaria

Two histograms


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expressed as a malaria alarm that could motivate the microscopicsearch for malaria.


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Modelos de prediccindiagnsticapara P.vivax y

P. falciparum

Dependientiende del observador (OD)

No dependiente del observador (N-OD)Algoritmo de deteccion en el Sysmex 2100


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Roman number: correspond to pixel counting areas


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Roman number: correspond to pixel counting areas


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XE-2100graphical analysis.


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XE-2100 graphical output analyses


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*summary images obtained using Photoshop forAFS


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BE (P. vivax group)

F (P. falciparum group)

***The larger WBC ghost group in the IMI scatterplot.


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In the P. vivax group, 98% had 1 of 10 possible abnormalities for the variable number of

granulocyte-coded DIFF abnormalities compared with 36% in theAFS group

The only P. falciparum sample with an abnormal scatterplot consisting of a second

eosinophil-coded group in the DIFF scatterplot also had the highest gametocytemia

PLT and RBC histograms showed extra peaks in both malaria groups but had lowreproducibility


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the lack of significant scatterplot abnormalities


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Compared with the AFS group, pixel counts were significantly higher in all six counting areas,

except the RET-EXT(IV) for P. vivax , and in none of the RETEXT areas for P. falciparum


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P. vivax mature trophozoites and schizonts showed a strong and significant

association with abnormalities in the DIFF, WBC/BASO, and RET-EXT

scatterplots followed by gametocytes and rings.


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*This identifies mononuclear and polymorphonuclear populations:

neutrophils

eosinophils

lymphocytes

monocytes

basophils

differential size (0)complexity (10).

granularity (90depolarized)lobularity (90polarized)


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CELL-Dyn 3500graphical analysis.


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multiple angle polarized light scattering patterns to subdivide the WBC categories


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optical

propertiesof their

granules

eosinophils areuniquely capable

of depolarizingand scattering alaser light beam

at 90 o.

Malaria pigmentlocated within WBC

shares this property,probably because of

the opticalcharacteristics ofmalaria pigment

products of malaria parasites to depolarize laser light reflected fromparticles designated as large mononuclear cells was exploited to identifymalaria parasites.


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several small particles (black)with a high degree offluorescence.

the abnormal cluster (black) Repeat specimen from case1, 3 days after presentation,showing disappearance of

abnormal cluster


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diagnostico de malaria mediante analizadores hematologicos automatizados

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