Figure 4

Normal and abnormal Sysmex XE-2100 scatter-plots where P. vivax -related findings have been identified. ^†Sysmex XE-2100 summary images composed of 50 superimposed images from samples without malaria, with lines delimiting where P. vivax- associated abnormalities appear. 1. neutrophils, outside limit (yellow line); 2. neutrophils, inferior deviation; 3. neutrophils, right deviation; 4. eosinophils, outside limit (yellow line); 5. confluent neutrophils and eosinophils; 6. granulocytes outside inferior limit; 7. ≥2 neutrophil-coded groups; 8. ≥2 eosinophil-coded groups; 9. tendency of granulocytes to form one group; 10. abnormal granulocyte colour (gray or normal). Variables 1 to 10 are used to obtain the Malaria Score (M-OD _{Pv ,} Figure 3). Pixel-counting areas were malaria related events appear are DIFF(I), DIFF(II), WBC/BASO(III), RET-EXT(IV), RET-EXT(V) and RET-EXT(VI). A. DIFF (SSC versus SFL) scatter-plot shows lymphocytes (magenta), monocytes (green), neutrophils (sky blue), eosinophils (red) and RBC ghosts (blue), non-identified events (gray). The malaria related abnormalities are shown in the images from three samples with 'P. vivax', for example, the duplication and fusion of the neutrophil and eosinophil groups (arrows) and gray-coded groups. B. WBC/BASO (SSC versus FSC) scatter-plot: Separates WBCs (sky blue) from basophils (gray). Malaria-related findings can be seen WBC/BASO(III) counting area (arrow). Malaria related findings that appear in the high SSC range of both the DIFF and WBC/BASO scatter-plot could be caused by haemozoin crystals in mature parasites [51]. C. RET-EXT (SFL versus FSC) scatter-plot: FSC differentiates RBC (high FSC, blue-magenta-red SLF progression) and platelets (low FSC, sky blue-green SFL progression) based on their size. Gray events usually correspond to WBC nuclear debris (high SFL). However, in P. vivax infected samples, †gray-coded events with middle and low FSC (arrows) and high SFL values can be found in the RET-EXT(V) and (VI) counting areas and could be generated by the parasite's nucleic acids [51].