{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:21:30Z","timestamp":1790774490525,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Malaria is a common and life\u2010threatening infection. Malaria diagnosis needs to be fast and reliable. Although malaria microscopy is currently the gold standard, it is laborious, requires extensive training, and relies heavily on the proficiency of microscopists. Though malaria rapid tests are widely used, they show poor sensitivity at low parasitemia levels, are affected by gene deletions, and offer only qualitative results. There is a need to explore new techniques for the diagnosis of malaria.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n A single\u2010center, cross\u2010sectional study evaluated the diagnostic performance of the Sysmex XN\u201031 automated analyzer for detecting malaria parasites compared to expert microscopy. The primary objective was to assess the XN\u201031's sensitivity, specificity, and ability to quantify malaria parasites relative to microscopy, the current gold standard. Blood samples from 310 adult patients undergoing routine malaria testing in a hospital setting were used. This included 118 confirmed malaria\u2010positive cases. The Sysmex XN\u201031 results were compared to blinded expert microscopy on the same samples. Dried blood spot samples were collected for any discrepancies and resolved using molecular testing.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This study analyzed 310 patient samples for malaria using both microscopy and the XN\u201031 analyzer. Microscopy identified 122 positive samples (39%), with\n P. falciparum<\/jats:italic>\n being the most prevalent species. Expert malaria microscopy demonstrated a sensitivity of 97.6% and a specificity of 100%. The XN\u201031 analyzer showed a sensitivity of 100% and a specificity of 99.46%. In malaria speciation, the XN\u201031 correctly flagged\n \n P.<\/jats:styled-content>\n falciparum\n <\/jats:italic>\n in 116 out of 117 cases (99.1%) among 125 positive cases. Additionally, five nonfalciparum malaria cases (\n \n Plasmodium<\/jats:styled-content>\n malariae\n <\/jats:italic>\n \u2014four cases and\n \n Plasmodium ovale<\/jats:italic>\n <\/jats:styled-content>\n \u2014one case) were accurately flagged as \u2018Malaria (Others).\u2019 However, five\n P. falciparum<\/jats:italic>\n cases were incorrectly flagged as \u2018Malaria (Others),\u2019 highlighting limitations in malaria speciation by the analyzer. Statistical analysis revealed a strong correlation (Spearman coefficient of 0.8) between the parasite density measured via microscopy and the XN\u201031. Passing\u2013Bablok regression indicated a strong linear relationship between these two methods.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The Sysmex XN\u201031 analyzer provides a quick and accurate method for the diagnosis of malaria. It detects, quantifies, and speciates plasmodium infections in less than 1\u2009minute. Our study showed that the analyzer shows high sensitivity and specificity comparable to those of expert microscopy in detecting\n Plasmodium<\/jats:italic>\n species, making it a promising alternative to current diagnostic methods. By overcoming the numerous limitations of existing tests, the XN\u201031 proves to be well\u2010suited for malaria testing, especially in malaria\u2010endemic regions.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ijlh.14456","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T12:57:04Z","timestamp":1741438624000},"page":"613-621","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Diagnostic Performance of a Sysmex\n XN<\/scp>\n \u201031 Automated Malaria Analyzer vs. Expert Microscopy"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5286-989X","authenticated-orcid":false,"given":"S.","family":"Onsongo","sequence":"first","affiliation":[{"name":"Aga Khan Hospital Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Otieno","sequence":"additional","affiliation":[{"name":"KEMRI Centre for Global Health Research (CGHR) Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Mathenge","sequence":"additional","affiliation":[{"name":"Aga Khan Hospital Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Makotsi","sequence":"additional","affiliation":[{"name":"Aga Khan Hospital Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Kariuki","sequence":"additional","affiliation":[{"name":"Aga Khan Hospital Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Ngetich","sequence":"additional","affiliation":[{"name":"Sysmex South Africa Randburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Muriithi","sequence":"additional","affiliation":[{"name":"Sysmex South Africa Randburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Sysmex South Africa Randburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Odawo","sequence":"additional","affiliation":[{"name":"KEMRI Centre for Global Health Research (CGHR) Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kariuki","sequence":"additional","affiliation":[{"name":"KEMRI Centre for Global Health Research (CGHR) Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.50"},{"key":"e_1_2_13_3_1","volume-title":"Global Technical Strategy for Malaria 2016\u20132030, 2021 Update","author":"World Health Organization","year":"2021"},{"key":"e_1_2_13_4_1","volume-title":"Malaria","author":"World Health Organization (WHO)","year":"2024"},{"key":"e_1_2_13_5_1","volume-title":"World Malaria Report 2022","year":"2022"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1042\/BST0380775"},{"key":"e_1_2_13_7_1","volume-title":"Medical Microbiology","author":"Crutcher J. 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