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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 2017, Article ID 9286392, 7 pages
https://doi.org/10.1155/2017/9286392
Research Article

Laboratory Diagnosis of Malaria: Comparison of Manual and Automated Diagnostic Tests

1Division of Immunology & Applied Microbiology, Department of Post Graduate Studies & Research, National Institute of Blood Diseases & Bone Marrow Transplantation, ST 2/A Block 17, Gulshan-e-Iqbal KDA Scheme 24, Karachi, Pakistan
2National Institute of Blood Diseases & Bone Marrow Transplantation, ST 2/A Block 17, Gulshan-e-Iqbal KDA Scheme 24, Karachi, Pakistan

Correspondence should be addressed to Samina Naz Mukry; moc.liamg@dbin.yrkums

Received 3 November 2016; Revised 16 February 2017; Accepted 21 February 2017; Published 5 April 2017

Academic Editor: Sandra Gemma

Copyright © 2017 Samina Naz Mukry et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Malaria is the second most prevalent disease in Pakistan resulting in ~30,000 annual deaths. In endemic countries like Pakistan precise and timely diagnosis of malaria is imperative to overcome the associated risks of fatal outcomes. Malarial parasite was screened in 128 malaria suspected patients and 150 healthy controls, by species-specific PCR, microscopy of blood smears, hemoanalyzer Sysmex XE-2100, and rapid test devices (First Response Malaria® and ICT Malaria Combo®). The microscopy detected MP in 126 samples (parasite load/µl 386–53712/µl); 71.094% were infected with Plasmodium vivax and 14.844% with P. falciparum while 14.062% had mixed P. vivax and P. falciparum infection. The mean parasite load for P. vivax and P. falciparum was 14496/µl and 24410/µl, respectively. The abnormal scattergrams of DIFF, WBC/ Baso, IMI channel, and RET-EXT on Sysmex XE-2100 supported 99.2% parasite detection, whereas only 93% of confirmed malaria cases were detected by both rapid tests. About 127 samples were positive by PCR. Since Sysmex XE-2100 automatically detected the presence of malarial parasite with high sensitivity, it can be a good option for presumptive diagnosis in endemic areas. Microscopy remains the gold standard to confirm MP in suspected patients. Rapid diagnostic tests have acceptable sensitivity and specificity.