Scatterplot Variations Seen in Malaria Using Automated Hematological Analyzers: A Series of Ten Cases

Authors

DOI:

https://doi.org/10.5195/ijms.2021.866

Keywords:

malaria, blood, diagnosis, analysis

Abstract

Background: Malaria is a major health problem in India. Complete blood count and peripheral blood smear (PBS) is important for its diagnosis. Inter observer variation makes PBS fallible. Rapid diagnostic tests cannot detect low parasitemia and mixed infections. Scatterplot from automated analyzers have shown variations previously which might be exploited.

Methods: Scatterplot patterns of ten samples of confirmed malaria and 100 control samples were derived and other infections ruled out by culture and serology as a part of descriptive study between July and August 2018. Each malarial scatterplot was compared with the control pattern for abnormalities and their frequency noted.

Results: All the ten samples belonged to Plasmodium vivax species. Abnormalities detected included split in neutrophilic region, eosinophil-neutrophil merge, neutrophil graying, lymphopenia, ghost red blood cells (RBC), eosinophil split, reactive lymphocytes, monocytosis, pseudoeosinophilia, neutrophilic leukocytosis

Conclusion: Variations in scatterplot patterns are seen in malaria and provide clues to the diagnosis of malaria.

Metrics

Metrics Loading ...

Author Biographies

Tavish Gupta, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry

Intern

Debdatta Basu, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER, Puducherry

Professor (Senior Scale) and Head, Department of Pathology

References

1. World Malaria Report 2018, Geneva : World Health Organization 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/275867/9789241565653-eng.pdf?ua = l
2. Nema S, Verma AK, Bharti PK. Strengthening diagnosis is key to eliminating malaria in India.The Lancet Infectious Diseases. 2019;19(12):1277–8.
3. Ohrt C, Purnomo, Sutamihardia MA, Tang D, Kain KC. Impact of microscopy error on estimates of protective efficacy in malaria prevention trials. J Infect Dis. 2002;186: 540–546.
4. Okell LC, Ghani AC, Lyons E, Drakeley CJ. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis 2009; 200: 1509–17.
5. Krishna S, Bharti PK, Chandel HS, Ahmad A, Kumar R, Singh PP, et al. Detection of Mixed Infections with Plasmodium spp. by PCR, India, 2014. Emerg Infect Dis. 2015;21(10):1853–7.
6. Chiodini PL, Bowers K, Jorgensen P, et al. The heat stability of plasmodium lactate dehydrogenase- based and histidine-rich protein 2-based malaria rapid diagnostic tests. Trans R Soc Trop Med Hyg 2007; 101: 331–37
7. Green R, Wachsmann-Hogiu S. Development, history, and future of automated cell counters. Clin Lab Med. 2015;35(1):1–10.
8. Juthani R, Basu D. Use of scatterplot patterns derived from automated haematological analysers in the diagnosis of acute febrile illnesses. J Clin Diagn Res [Internet]. 2020; Available from: http://dx.doi.org/10.7860/jcdr/2020/43171.13491
9. Singh A, Narang V, Sood N, Garg B, Gupta VK. Malaria diagnosis using automated analysers: A boon for hematopathologists in endemic areas. Journal of Clinical and Diagnostic Research: JCDR. 2015; 9(10):EC05-8.
10. Jain M, Gupta S, Jain J, Grover RK. Usefulness of automated cell counter in detection of malaria in a cancer set up-Our experience. Indian J Pathol Microbiol 2012;55:467-73
11. Sharma S, Sethi N, Pujani M, Kushwaha S, Sehgal S. Abnormal WBC scattergram: a clue to the diagnosis of malaria. Hematology. 2013;18(2):101–5.
12. Hill VL, Simpson VZ, Higgins JM, Hu Z, Stevens RA, Metcalf JA, et al. Evaluation of the performance of the sysmex XT-2000i hematology analyzer with whole bloods stored at room temperature. Lab Med. 2009;40(12):709–18.
13. Dhiman S, Veer V, Dev V. Declining transmission of malaria in India: Accelerating towards elimination. In: Towards Malaria Elimination - A Leap Forward. InTech; 2018.
14. Buoro S, Manenti B, Seghezzi M, Moioli V, Bagorria M, Callegaro A, et al. Abnormal scattergrams and cell population data generated by fully automated hematological analyzers: New tools for screening malaria infection? Int J Lab Hematol. 2018;40(3):326–34.
15. Mohapatra S, Samantaray JC, Arulselvi S, Panda J, Munot K, Saxena R. Automated detection of malaria with haematology analyzer Sysmex XE-2100. Indian J Med Sci 2011; 65:26-31.
16. Campuzano-Zuluaga G, Hänscheid T, Grobusch MP. Automated haematology analysis to diagnose Malaria. Malaria Journal 2010, 9:346.
17. Mubeen KH, Devadoss CW, Rangan RA, Gitanjali M, Prasanna S and VP Sunitha. Automated Hematology Analyzers in Diagnosis of Plasmodium vivax Malaria: an Adjunct to Conventional Microscopy. Mediterr J Hematol Infect Dis. 2014 Jun 1; 6(1):e2014034
18. Huh J, Jung J, Yoon H, Chung W. Pseudoeosinophilia associated with malaria infection determined in the Sysmex XE-2100 hematology analyzer. Ann Hematol. 2005;84(6):400–2.
19. Sharma S, Sethi N, Pujani M, Kushwaha S, Sehgal S. Abnormal WBC scattergram: a clue to the diagnosis of malaria. Hematology. 2013;18(2):101–5.
20. Yoo J-H, Song J, Lee K-A, Sun Y-K, Kim Y-A, Park TS, et al. Automated detection of malaria-associated pseudoeosinophilia and abnormal WBC scattergram by the Sysmex XE-2100 hematology analyzer: a clinical study with 1,801 patients and real-time quantitative PCR analysis in vivax malaria-endemic area. Am J Trop Med Hyg. 2010;82(3):412–4.

Downloads

Published

2021-04-29

How to Cite

Juthani, R., Gupta, T., & Basu, D. (2021). Scatterplot Variations Seen in Malaria Using Automated Hematological Analyzers: A Series of Ten Cases. International Journal of Medical Students, 9(1), 21–24. https://doi.org/10.5195/ijms.2021.866

Issue

Vol. 9 No. 1 (2021)

Section

Original Article

Categories

License

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
    2. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
    3. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
    4. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
    5. The Author represents and warrants that:
      1. the Work is the Author’s original work;
      2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
      3. the Work is not pending review or under consideration by another publisher;
      4. the Work has not previously been published;
      5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
      6. the Work contains no libel, invasion of privacy, or other unlawful matter.
    6. The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Enforcement of copyright

The IJMS takes the protection of copyright very seriously.

If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.

If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org

 

Infringing material

If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org