Usefulness of histogram study in diagnosis of malaria: our experience at tertiary care center

Original Article

Author Details : Varsha Somabhai Khant, Hansa Goswami

Volume : 3, Issue : 4, Year : 2016

Article Page : 458-463

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Background: Malaria diagnosis presents a challenge to all laboratories. Especially post monsoon season, there is a need for rapid, sensitive and cost effective method to effectively screen all samples, especially when workload is very high. Automated cell counters offer rapid, sensitive and cost effective screening of all samples.
Aims and objective: To evaluate the usefulness of automated cell counters analysing their histograms, scatter-grams and the flaggings generated in malaria positive cases. To compare other parameters which could help to identify malaria parasite in microscopic examination of peripheral smear.
Methods: The study was conducted in the laboratory of B. J. Medical College, civil hospital, Ahmedabad12 months of duration from November 2014 to November 2015. 775 samples from the patients who presented to emergency department and for whom the attending clinicians had requested full blood count and malaria smears were included in the study. Samples were processed as part of normal routine cell dyn ruby analyser for FBC (Full Blood Count). We had used histograms and scatterplots which were generated by cell dyn ruby and interpreted the histograms in malarial cases.
Result: Total 775 cases were studied, out of which 409 cases were positive for malaria which are confirmed by peripheral smear examination.409 positive cases were evaluated, abnormal scattergram were observed in 98% cases of malaria while abnormal WBC histogram peaks were noted in 92% cases of malaria. Haematological parameters such as anaemia, leucopenia, Monocytosis, atypical lymphocytosis, atypical eosinophilia, pink flag were also important for diagnosis.
Conclusion: This method of histogram study in malaria is a useful addition to conventional microscopy. Beneficial part of this study is that where workload is high and clinician send only CBC (complete blood count), in such circumstances histogram study in automated analysers as we have used cell dyn ruby in our institute, we can diagnose malaria. If we have trained staff for histogram and scattergram of automated analysers so we cannot miss sample in initial screening.

Keywords: Automation, histogram, Pink flag, WBC Scattergram, Malaria, atypical lymphocytes

How to cite : Khant V S, Goswami H, Usefulness of histogram study in diagnosis of malaria: our experience at tertiary care center. Indian J Microbiol Res 2016;3(4):458-463

Copyright © 2016 by author(s) and Indian J Microbiol Res. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (

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