Korean J Lab Med.  2008 Oct;28(5):332-338. 10.3343/kjlm.2008.28.5.332.

Evaluation of Usefulness of the Panel Test Composed of Malaria Non-specific Tests As a Surrogate Marker

• Kang YH
• Lim HS
• Lee HM
• Lee KS
• Choi KM

• KMID: 1781564
• DOI: http://doi.org/10.3343/kjlm.2008.28.5.332

Abstract

BACKGROUND: Although malaria-specific antibody or antigen test is useful for the diagnosis of malaria infection, its cost-effectiveness has to be concerned in the area where malaria prevalence is very low. We created a panel test composed of malaria non-specific parameters, namely hematology autoanalyzer-derived results with or without addition of HDL-cholesterol data, and evaluated its usefulness in comparison with malaria-specific antibody test.
METHODS
For 395 patients tested for malaria smear, the hematology parameters such as platelet count, NRBC (%) and VCS (volume, conductivity, scattering) parameters of WBC, and HDL-cholesterol data were analyzed. Statistical significance of each parameter and that of panel test with or without addition of HDL-cholesterol were evaluated.
RESULTS
Malaria antibody test showed sensitivity of 97.1% and specificity of 99.1%. Each parameter of platelet count, NRBC (%), D parameter and HDL-cholesterol showed sensitivity of 86.8%, 41.2%, 81.8%, and 70.6%, and specificity of 85.9%, 96.3%, 72.3%, and 81.7%, respectively. Panel test without including HDL-cholesterol showed sensitivity of 91.2% and specificity of 81.6%, and that including HDL-cholesterol showed sensitivity of 91.2% and specificity of 86.2%.
CONCLUSIONS
The malaria non-specific panel test composed of hematology autoanalyzer-derived parameters showed relatively good, but slightly lower sensitivity than that of malaria-specific antibody test. It might be used as a screening test for the diagnosis of malaria infection, and addition of HDL cholesterol improved little the usefulness of the panel test.

Keyword

Malaria; Diagnosis; Hematology autoanalyzer; HDL-cholesterol

MeSH Terms

Animals
Autoanalysis
Biological Markers
Cholesterol, HDL/*blood
Diagnosis, Differential
Hematologic Tests/economics/utilization
Humans
Malaria, Falciparum/blood/*diagnosis
Plasmodium falciparum/isolation & purification
ROC Curve
Reagent Kits, Diagnostic
Sensitivity and Specificity

Figure

• 

  Fig. 1. Comparison of ROC curves for panel test 1 & 2. P1 is composed of platelet count, NRBC (%) and D parameter derived from volume, conductivity, scattering indices, and P2 is composed of P1 plus HDL-cholesterol. HDL-cholesterol is not helpful to increase the sensitivity or specificity of the panel test.

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