@Article{
AUTHOR = {Kiki Barro, Pulchérie Christiane Kiki Barro and Yaudé, Eugénie Yaudé and Angora, Kpongbo Etienne Angora and Kouadio, Lemaitre Hardy Emmanuella Kouadio and Miézan, Assohoun Jean Sébastien Miézan and Bédia-Tanoh, Valérie Akoua Bédia-Tanoh and Koné, Gnanyo Massafoma Estelle Koné and Vanga-Bosson, Abo Henriette Vanga-Bosson and Kassi, Fulgence Kondo Kassi and Konaté-Touré, Abibatou Konaté-Touré and Djohan, Vincent Djohan and Menan, Eby Ignace Hervé Menan and Yavo, William Yavo},
TITLE = {Diagnostic Performance of the Sysmex XN-31™ Automated Analyzer for Detecting Asymptomatic Malaria Among Blood Donors: A Comparative Cross-Sectional Study at the Regional Blood Transfusion Center of Abidjan, Côte d’Ivoire},
JOURNAL = {African Journal of Parasitology, Mycology and Entomology},
VOLUME = {3},
YEAR = {2026},
NUMBER = {2},
PAGES = {0--0},
URL = {https://ajpme.jams.pub/article/3/2/295},
ISSN = {1987-1473},
ABSTRACT = {Introduction: In malaria-endemic regions, asymptomatic Plasmodium carriage among blood donors poses a persistent threat to transfusion safety. The Sysmex XN-31™, an automated hematology analyzer that uses fluorescence flow cytometry, is a promising tool for rapidly detecting and analyzing malaria-infected red blood cells. Methods: We conducted a comparative cross-sectional study at the Regional Blood Transfusion Center of Abidjan during a low-transmission season. Blood samples from asymptomatic adult donors were screened using both Sysmex XN-31™ and microscopy on Giemsa-stained blood smears. The diagnostic performance was assessed using microscopy as the reference method, and inter-method agreement was determined using Cohen’s kappa. Molecular confirmation was not performed. Results: Among 520 donors (78% male; mean age 34.7 ± 11 years), Sysmex XN-31™ detected 10 Plasmodium-positive cases (prevalence 1.92%; 95% CI: 1.04–3.50) compared to 4 cases detected by microscopy (0.77%; 95% CI: 0.30–1.96). Half of the Sysmex XN-31™-positive samples had low parasitemia (20–100 parasites/µL), sensitivity was 100% (95% CI: 39.8–100), specificity was 98.8% (95% CI: 97.4–99.5), and Cohen’s kappa was 0.57. Five samples (1.0%) yielded indeterminate Sysmex XN-31™ results. Conclusion: Sysmex XN-31™ proved to be highly sensitive and specific in identifying asymptomatic malaria, particularly for the detection of low parasitemia levels. An integrative algorithm combining primary Sysmex XN-31™ screening with molecular confirmation for positive or indeterminate results is recommended. Multicenter evaluations that incorporate molecular confirmation and cost-effective analysis are warranted to further validate these findings.},
DOI = {10.35995/ajpme03020014}
}