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Flagging performance of Sysmex XN-10 haematology analyser for malaria detection
  1. Cécile Dumas1,
  2. Pauline Tirard-Collet2,
  3. Fanélie Mestrallet3,
  4. Sandrine Girard3,
  5. Laurent Jallades4,
  6. Stéphane Picot2,5,
  7. Anne-Lise Bienvenu1,5
  1. 1Service d'Hématologie Biologique, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
  2. 2Service de Parasitologie et Mycologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
  3. 3Service d'Hématologie Biologique, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
  4. 4Service d'Hématologie Biologique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
  5. 5Malaria Research Unit, SMITh, ICBMS UMR 5246 CNRS, Université de Lyon, Faculte de Medecine Lyon-Est, Lyon, France
  1. Correspondence to Dr Cécile Dumas, Service d'hématologie biologique - Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France; cecile.dumas{at}


Aim The aim was to assess the flagging performance of Sysmex XN-10 haematology analyser for malaria detection through the parasitic red blood cell (‘pRBC’) alarm.

Methods We retrospectively studied 584 blood samples performed on the Sysmex XN-10 analyser that were tested for malaria. Sensitivity, specificity, positive and negative predictive values, and prevalence were established for the pRBC alarm.

Results Sensitivity, specificity, and positive and negative predictive values for the pRBC flag were 7.8%, 100%, 100% and 87.7%, respectively. The prevalence of pRBC flag of 0.026% in the overall population was significantly different from the prevalence of 1.027% in the population tested for malaria.

Conclusions Considering the excellent specificity and the low prevalence of the flag in the overall population, we suggest, in case of the presence of pRBC flag, the implementation of a rapid review of the blood smear looking for Plasmodium, mostly if the patient had fever and had not been tested for malaria.

  • malaria
  • haematology
  • automated screening
  • automation

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  • Handling editor Mary Frances McMullin.

  • Contributors CD designed the study. CD, PT-C and A-LB analysed the data and wrote the manuscript. CD, SG, FM and LJ were responsible for the haematological data in the laboratory. PT-C participated in the malaria diagnosis and SP was responsible for the malaria diagnosis. All authors reviewed the manuscript and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical clearance was unnecessary as there was no extra sample required and results were not used for diagnostic purposes.

  • Provenance and peer review Not commissioned; externally peer reviewed.