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Design of Malaria Diagnostic Criteria for the Sysmex XE-2100 Hematology Analyzer

Germán Campuzano-ZuluagaGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Gonzalo Álvarez-SánchezGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Gloria Elcy Escobar-GalloGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Luz Marina Valencia-ZuluagaGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Alexandra Marcela Ríos-OrregoGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Adriana Pabón-VidalGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Andrés Felipe Miranda-ArboledaGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Silvia Blair-TrujilloGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Germán Campuzano-MayaGrupo Malaria, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia; Laboratorio Clínico Hematológico, Medellín, Colombia

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Thick film, the standard diagnostic procedure for malaria, is not always ordered promptly. A failsafe diagnostic strategy using an XE-2100 analyzer is proposed, and for this strategy, malaria diagnostic models for the XE-2100 were developed and tested for accuracy. Two hundred eighty-one samples were distributed into Plasmodium vivax, P. falciparum, and acute febrile syndrome groups for model construction. Model validation was performed using 60% of malaria cases and a composite control group of samples from AFS and healthy participants from endemic and non-endemic regions. For P. vivax, two observer-dependent models (accuracy = 95.3–96.9%), one non–observer-dependent model using built-in variables (accuracy = 94.7%), and one non–observer-dependent model using new and built-in variables (accuracy = 96.8%) were developed. For P. falciparum, two non–observer-dependent models (accuracies = 85% and 89%) were developed. These models could be used by health personnel or be integrated as a malaria alarm for the XE-2100 to prompt early malaria microscopic diagnosis.

Author Notes

*Address correspondence to Germán Campuzano-Zuluaga, Laboratorio Clínico Hematológico, Carrera 43C No. 5-33, Medellín, Colombia 050022. E-mail: germancz81@gmail.com

Financial support: This study was funded by the Laboratorio Clínico Hematológico S.A. Medellín, Colombia and the Grupo Malaria, Universidad de Antioquia, Medellín, Colombia.

Disclosure: Some of the authors wish to disclose that they have received technical support (two consultancies) from the Sysmex Corporation regarding this project in relation to accessing the hematology analyzer's technical variable database. No direct funding or benefits such as trips, conference participations, or commercial contracts have been offered or received by Sysmex Corporation regarding the research presented in the submitted paper. This statement is made in the interest of full disclosure and not because the authors consider this to be a conflict of interest.

Authors' addresses: Germán Campuzano-Zuluaga, Gonzalo Álvarez-Sánchez, Alexandra Marcela Ríos-Orrego, Adriana Pabón-Vidal, Andrés Felipe Miranda-Arboleda, and Silvia Blair-Trujillo, Grupo Malaria, Universidad de Antioquia, Medellín, Colombia, E-mails: germancz81@gmail.com, gonzalv@quimbaya.udea.edu.co, alexrioso@hotmail.com, apabon72@gmail.com, mirandaarboleda@gmail.com, and sblair@quimbaya.udea.edu.co. Germán Campuzano-Zuluaga, Gloria Elcy Escobar-Gallo, Luz Marina Valencia-Zuluaga, and Germán Campuzano-Maya, Laboratorio Clínico Hematológico, Medellín, Colombia, E-mails: germancz81@gmail.com, lablch@hematologico.com, comunicaciones@hematologico.com, and gcampuzano@hematologico.com.

Reprint requests: Germán Campuzano-Zuluaga, Laboratorio Clínico Hematológico, Carrera 43C No. 5-33, Medellín, Colombia 050022, E-mail: germancz81@gmail.com.

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