White blood cell (WBC) and neutrophil counts are important laboratory tests used by clinicians to assess a variety of conditions. However, current methods to measure WBC and neutrophil counts are difficult to perform at the point of care, being either cost or labor prohibitive. To meet this need, we developed the LeukoScope: a portable, imaging-based system to measure WBC and neutrophil counts from a drop of blood. Here, we present the performance of the LeukoScope in 136 pediatric and 164 neonatal subjects at a central hospital in Malawi. For pediatric patients, 95.4, 66.7, and 80.0% of samples with normal, low, and high WBC counts, respectively, were correctly identified, and 88.6, 100.0, and 89.3% of samples with normal, low, and high neutrophil counts, respectively, were correctly identified. Accuracy was lower overall for neonatal samples; 92.1, 64.3, and 26.7% of samples with normal, low, and high WBC counts, respectively, were correctly identified, and 73.2 and 78.6% of samples with normal and high neutrophil counts, respectively, were correctly identified. Results of this study show that the LeukoScope can help meet need for point-of-care measurement of WBC counts in pediatric patients and highlight the challenges of point-of-care assessment of WBC counts in neonatal patients.
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This work was supported by Grant #2013138 from the Doris Duke Charitable Foundation. This work was funded by Grant #OPP1028843 from the Bill and Melinda Gates Foundation through the Grand Challenges in Global Health Initiative. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. 1450681. The authors would like to acknowledge the members of the Rice360 Institute for Global Health team in Blantyre, Malawi for their support in administration and logistics in running this clinical trial, notably the assistance of Prince Mtenthaonga for his assistance with patient enrollment and sample collection, and Cynthia Wong for her assistance with optical system performance analysis.
Author information Authors and AffiliationsDepartment of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX, 77005, USA
Catherine E. Majors, Michal E. Pawlowski, Tomasz S. Tkaczyk & Rebecca Richards-Kortum
Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi
Queen Dube
Correspondence to Rebecca Richards-Kortum.
Additional informationAssociate Editor Stefan M. Duma oversaw the review of this article.
Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article Cite this articleMajors, C.E., Pawlowski, M.E., Tkaczyk, T.S. et al. Evaluation of the LeukoScope for Point-of-Care Measurement of White Blood Cell and Neutrophil Counts in Malawi. Ann Biomed Eng 49, 2566–2578 (2021). https://doi.org/10.1007/s10439-021-02827-7
Received: 19 April 2021
Accepted: 28 June 2021
Published: 09 July 2021
Issue Date: September 2021
DOI: https://doi.org/10.1007/s10439-021-02827-7
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