TY  - EJOU
AU  - Kiki Barro, K. Pulchérie Christiane
AU  - Yaudé, Y. Eugénie
AU  - Angora, A. Kpongbo Etienne
AU  - Kouadio, K. Lemaitre Hardy Emmanuella
AU  - Miézan, M. Assohoun Jean Sébastien
AU  - Bédia-Tanoh, B. Valérie Akoua
AU  - Koné, K. Gnanyo Massafoma Estelle
AU  - Vanga-Bosson, V. Abo Henriette
AU  - Kassi, K. Fulgence Kondo
AU  - Konaté-Touré, K. Abibatou
AU  - Djohan, D. Vincent
AU  - Menan, M. Eby Ignace Hervé
AU  - Yavo, Y. William
TI  - 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
T2  - African Journal of Parasitology, Mycology and Entomology

PY  - 2026
VL  - 3
IS  - 2
SN  - 1987-1473

AB  - 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.
KW  - asymptomatic malaria
KW  - blood donors
KW  - Sysmex XN-31™
KW  - diagnostic performance
KW  - screening algorithm
DO  - 10.35995/ajpme03020014