The diagnosis of malaria infection using a solid-phase radioimmunoassay for the detection of malaria antigens. Application to the detection of Plasmodium berghei infection in mice

Laboratory Detection of Malaria Antigens: a Strong Tool for Malaria Research, Diagnosis, and Epidemiology

The identification and characterization of proteins produced during human infection with Plasmodium spp. have guided the malaria community in research, diagnosis, epidemiology, and other efforts. Recently developed methods for the detection of these proteins (antigens) in the laboratory have provided new types of data that can inform the evaluation of malaria diagnostics, epidemiological investigations, and overall malaria control strategies. Here, the focus is primarily on antigens that are currently known to be detectable in human specimens and on their impact on the understanding of malaria in human populations. We highlight historical and contemporary laboratory assays for malaria antigen detection, the concept of an antigen profile for a biospecimen, and ways in which binary results for a panel of antigens could be interpreted and utilized for different analyses. Particular emphasis is given to the direct comparison of field-level malaria diagnostics and laboratory antigen detection for the development of an external evaluation scheme. The current limitations of laboratory antigen detection are considered, and the future of this developing field is discussed.

Detection of malaria endemicity in community villages in North Sumatra, Indonesia by enzyme linked immunosorbent assay

An enzyme linked immunosorbent assay for malaria was used in North Sumatra, Indonesia as an epidemiological survey tool. The seroepidemiological investigation was concentrated on junior high schools. Serum samples obtained were classified according to the villages of origin of the students. The mean of ELISA values of each village group was compared with the parasite rate in primary schools in their native villages. A good correlation was observed between them (r = 0.96). The present results indicate that a survey of malaria in junior high schools by ELISA could give useful information on malaria prevalence in several peripheral villages. Province-wide information on malaria prevalence could easily be obtained by malaria-ELISA in junior high schools in tropical rural area.

Detection of Plasmodium falciparum using a radioimmunoassay based on a crossreacting, monoclonal anti-P. berghei antibody-P. berghei antigen system

An antibody binding-inhibition test is described, which allows the detection of P. falciparum in red blood cells (RBC) infected in vitro, using a crossreacting, monoclonal anti-P. berghei antibody and P. berghei coated microtiter plates. Experiments carried out to determine the coating efficiency of various P. berghei and P. falciparum derived antigen preparations showed that intact, saponin freed P. berghei parasites and sonicated, RBC parasitized with P. falciparum had the highest binding activity. Binding of the monoclonal antibody to the antigen coated plates was effectively inhibited by preincubation with sonicated, P. falciparum infected RBC. The minimal degree of infection detectable was about 0.008% parasitemia (400 parasitized RBC/microliters blood). The sensitivity of detection was not appreciably affected by the source of the coating antigen. We conclude that the difficulty and expense involved in the use of P. falciparum based immunodiagnostic tests for large scale screening for malaria can be obviated by making use of P. berghei based assays.

Malaria diagnosis by enzyme-linked immunosorbent assays

Enzyme-linked immunosorbent assays (ELISA) for detecting malarial parasites in blood were tested on uninfected monkeys and in monkeys infected with Plasmodium falciparum. A double antibody sandwich ELISA detected one malarial cell per 10(3) uninfected cells, and an inhibition ELISA detected on infected cell per 10(4) uninfected erythrocytes. These methods are not yet as sensitive as conventional blood-film examinations, in which a well-trained microscopist might be expected to detect one malarial cell per 10(6) erythrocytes. Nevertheless, ELISA offers an objective means of detecting malaria and is particularly advantageous since up to 100 samples may be processed simultaneously.