Utility of Abnormal WBC Scattergram & Pseudo Eosinophilia with Thrombocytopenia in Presumptive Diagnosis of Malaria

Background: Malaria remains a major global health problem, and while Giemsa-stained peripheral blood smear microscopy is the diagnostic gold standard, it is limited by interobserver variability and resource constraints in many endemic settings. Automated haematology analysers, routinely used for complete blood counts, may provide valuable presumptive diagnostic clues through characteristic haemogram changes and abnormal WBC scattergram patterns. Aim: To evaluate the utility of abnormal WBC scattergram patterns and pseudoeosinophilia, in combination with thrombocytopenia and other haemogram abnormalities, as indicators for the presumptive diagnosis of malaria. Materials and Methods: This was a descriptive study in retrospective analysis of all malaria positive cases. It was conducted over four months (August–November 2023) at Dr SN Medical College and associated hospitals, Jodhpur. A total of 1,200 EDTA blood samples from patients clinically suspected of malaria were analysed using the Sysmex XS-800i automated haematology analyser, and corresponding Giemsa-stained thick and thin peripheral blood smears were examined microscopically for Plasmodium species. Pseudoeosinophilia was defined as a spurious increase in eosinophil count on the analyser not corroborated by manual differential counts, thrombocytopenia as platelet count