%0 Journal Article
%A Kiki Barro, Pulchérie Christiane Kiki Barro
%A Yaudé, Eugénie Yaudé
%A Angora, Kpongbo Etienne Angora
%A Kouadio, Lemaitre Hardy Emmanuella Kouadio
%A Miézan, Assohoun Jean Sébastien Miézan
%A Bédia-Tanoh, Valérie Akoua Bédia-Tanoh
%A Koné, Gnanyo Massafoma Estelle Koné
%A Vanga-Bosson, Abo Henriette Vanga-Bosson
%A Kassi, Fulgence Kondo Kassi
%A Konaté-Touré, Abibatou Konaté-Touré
%A Djohan, Vincent Djohan
%A Menan, Eby Ignace Hervé Menan
%A Yavo, William Yavo
%D 2026
%J African Journal of Parasitology, Mycology and Entomology

%@ 1987-1473

%V 3
%N 2
%P 14

%T 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
%M doi:10.35995/ajpme03020014
%U https://ajpme.jams.pub/article/3/2/295
%X 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.