Is flow cytometry better in counting malaria pigment-containing leukocytes compared to microscopy?

Malar J. 2009 Nov 16;8:255. doi: 10.1186/1475-2875-8-255.


Background: Detection of malaria pigment (or haemozoin; Hz)-containing leukocytes may have prognostic relevance in malaria; however, studies reported conflicting results, with microscopic counts suggestive of being inaccurate and imprecise.

Methods: Numbers of Hz-containing leukocytes from a malaria patient obtained with a flow cytometer counting 50.000 gated events were compared with thin film microscopy as applied under field conditions.

Results: Flow cytometry identified 5.8% Hz-containing monocytes and 1.8% Hz-containing neutrophils. The microscopic examination yielded 10% and 13% of Hz-containing monocytes, as well as 0% and 0.5% of Hz-containing neutrophils for observers one and two, respectively.

Conclusion: Novel, robust and affordable cytometric methods should be evaluated in the field as they may assist in utilizing Hz-containing cells as clinically useful parameter.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Flow Cytometry / methods*
  • Hemeproteins
  • Humans
  • Leukocyte Count / methods*
  • Leukocytes / chemistry*
  • Malaria / diagnosis*
  • Microscopy
  • Pigments, Biological / blood
  • Sensitivity and Specificity


  • Hemeproteins
  • Pigments, Biological
  • hemozoin