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Yadav A, Verma K, Singh K, Tyagi S, Kori L, Bharti PK. Analysis of Diagnostic Biomarkers for Malaria: Prospects on Rapid diagnostic test development. Microb Pathog 2024:106978. [PMID: 39321969 DOI: 10.1016/j.micpath.2024.106978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/20/2024] [Accepted: 09/22/2024] [Indexed: 09/27/2024]
Abstract
Accurate malaria diagnosis remains a formidable challenge in remote regions of malaria-endemic areas globally. Existing diagnostic methods predominantly rely on microscopy and rapid diagnostic tests (RDTs). While RDTs offer advantages such as rapid results and reduced dependence on highly skilled technicians compared to microscopy, persistent challenges emphasize the critical need to identify novel diagnostic biomarkers to further enhance RDT based malaria diagnosis. This comprehensive review presents a range of promising diagnostic targets. These targets could be useful in developing more robust, accurate, and effective diagnostic tools. Such tools are crucial for the detection of the Plasmodium falciparum malaria parasite. The potential biomarkers discussed here significantly address the challenges posed by HRP2 gene deletion in P.falciparum. Researchers, RDT manufacturers, industrial and other stakeholders involved in malaria diagnosis can harness the crucial information describe in this article, to drive the development of advanced RDTs as viable alternatives. The potential biomarkers discussed here significantly in address the challenges posed by HRP2 gene deletion in P.falciparum. By diversifying the available tools for diagnosis, we can attempt to enhance our ability to knock out malaria effectively and contribute to better health outcomes for peoples residing in malaria-endemic regions. This review serves as a valuable resource for advancing research and development in the field of malaria diagnostics, ultimately aiding to the global fight against this devastating ancient disease.
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Affiliation(s)
- Ankit Yadav
- Department of Molecular Epidemiology, ICMR-NIMR, Dwarka-Delhi-110077
| | - Kanika Verma
- Department of Molecular Epidemiology, ICMR-NIMR, Dwarka-Delhi-110077
| | - Kuldeep Singh
- Department of Molecular Epidemiology, ICMR-NIMR, Dwarka-Delhi-110077
| | - Suchi Tyagi
- Department of Molecular Epidemiology, ICMR-NIMR, Dwarka-Delhi-110077
| | - Lokesh Kori
- Department of Molecular Epidemiology, ICMR-NIMR, Dwarka-Delhi-110077
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Hoang VT, Hong H, Eom TH, Park H, Yeo SJ. A novel peptide pair-based rapid fluorescent diagnostic system for malaria Plasmodium falciparum detection. Talanta 2024; 281:126828. [PMID: 39265425 DOI: 10.1016/j.talanta.2024.126828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/11/2024] [Accepted: 09/05/2024] [Indexed: 09/14/2024]
Abstract
Advanced diagnostic materials, such as aptamers, are required due to the scarcity of efficient diagnostic antibodies and the low sensitivity of rapid diagnostic kits at detecting the malaria parasite, Plasmodium falciparum. METHODS Two peptides M2.9 [(KPTAEQTESPELQSAPEN) and M2.17 (KILFNVYSPLGCTCECWV)] were designed using simple epitope prediction tools and modified against the merozoite surface antigen 2 of P. falciparum (Pf.MSP2) by 3-dimensional modeling based on binding affinity. Based on five prediction tools for hydropathy, M2.17 was selected as an appropriate capture peptide. A peptide-based fluorescence-linked immunosorbent assay (FLISA) and a peptide pair-based fluorescent immunochromatographic test strip (FICT) were developed to detect P. falciparum 3D7 (drug-sensitive) and P. falciparum K1 (multi drugs-resistant) strains. RESULTS Bioinformatic analysis of two peptides demonstrated the potential binding affinity with the merozoite surface protein 2 of P. falciparum (Pf.MSP2) with a positive hydropathy value. The limit of detection (LOD) of FLISA was 10 parasites/μL and of a peptide pair-linked rapid FICT system was 5 and 200 parasites/μL for P. falciparum 3D7 and K1, respectively. Compared to commercial rapid detection systems (RDTs), a peptide pair-linked FICT system exhibited a 20-fold greater efficiency in detecting P. falciparum 3D7 and specifically discriminated another protozoan spp. CONCLUSION A peptide pair-linked rapid diagnostic strip could be an alternative to conventional RDTs for monitoring wild-type and drug-resistant malaria parasites.
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Affiliation(s)
- Vui Thi Hoang
- Zoonosis Research Center, Department of Infection Biology, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Hyelee Hong
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - Tae-Hui Eom
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - Hyun Park
- Zoonosis Research Center, Department of Infection Biology, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Seon-Ju Yeo
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; Medical Research Center, Institute of Endemic Diseases, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea.
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Choi JW, Ha SO, Kim YJ, Shin JS, Choi MJ, Yu SE, Han J, Park EJ, Park KS, Kang JH. Characterization of Escherichia coli Strains for Novel Production of Plasmodium ovale Lactate Dehydrogenase. Microorganisms 2024; 12:876. [PMID: 38792706 PMCID: PMC11123484 DOI: 10.3390/microorganisms12050876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Malaria is one of the most prevalent diseases worldwide with high incidence and mortality. Among the five species that can infect humans, Plasmodium ovale morphologically resembles Plasmodium vivax, resulting in misidentification and confusion in diagnosis, and is responsible for malarial disease relapse due to the formation of hypnozoites. P. ovale receives relatively less attention compared to other major parasites, such as P. falciparum and P. vivax, primarily due to its lower pathogenicity, mortality rates, and prevalence rates. To efficiently produce lactate dehydrogenase (LDH), a major target for diagnosing malaria, this study used three Escherichia coli strains, BL21(DE3), BL21(DE3)pLysS, and Rosetta(DE3), commonly used for recombinant protein production. These strains were characterized to select the optimal strain for P. ovale LDH (PoLDH) production. Gene cloning for recombinant PoLDH production and transformation of the three strains for protein expression were performed. The optimal PoLDH overexpression and washing buffer conditions in nickel-based affinity chromatography were established to ensure high-purity PoLDH. The yields of PoLDH expressed by the three strains were as follows: BL21(DE3), 7.6 mg/L; BL21(DE3)pLysS, 7.4 mg/L; and Rosetta(DE3), 9.5 mg/L. These findings are expected to be highly useful for PoLDH-specific diagnosis and development of antimalarial therapeutics.
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Affiliation(s)
- Jae-Won Choi
- Department of Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Pharmaceutical and Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
| | - Sang-Oh Ha
- Department of Pharmaceutical and Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
| | - Yeon-Jun Kim
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Jun-Seop Shin
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Min-Ji Choi
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Si-Eun Yu
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Junghun Han
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Eun-Ji Park
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Kyoung Sik Park
- Department of Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Pharmaceutical and Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
| | - Jung Hoon Kang
- Department of Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Pharmaceutical and Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
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Pawłowska M, Mila-Kierzenkowska C, Szczegielniak J, Woźniak A. Oxidative Stress in Parasitic Diseases-Reactive Oxygen Species as Mediators of Interactions between the Host and the Parasites. Antioxidants (Basel) 2023; 13:38. [PMID: 38247462 PMCID: PMC10812656 DOI: 10.3390/antiox13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Oxidative stress plays a significant role in the development and course of parasitic infections, both in the attacked host organism and the parasite organism struggling to survive. The host uses large amounts of reactive oxygen species (ROS), mainly superoxide anion (O2•-) and hydrogen peroxide (H2O2), to fight the developing parasitic disease. On the other hand, the parasite develops the most effective defense mechanisms and resistance to the effects of ROS and strives to survive in the host organism it has colonized, using the resources and living environment available for its development and causing the host's weakening. The paper reviews the literature on the role of oxidative stress in parasitic diseases, which are the most critical epidemiological problem worldwide. The most common parasitosis in the world is malaria, with 300-500 million new cases and about 1 million deaths reported annually. In Europe and Poland, the essential problem is intestinal parasites. Due to a parasitic infection, the concentration of antioxidants in the host decreases, and the concentration of products of cellular components oxidation increases. In response to the increased number of reactive oxygen species attacking it, the parasites have developed effective defense mechanisms, including primarily the action of antioxidant enzymes, especially superoxide dismutase and nicotinamide adenine dinucleotide phosphate hydrogen (NADPH)-dependent complexes glutathione and thioredoxin.
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Affiliation(s)
- Marta Pawłowska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
| | - Celestyna Mila-Kierzenkowska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
| | - Jan Szczegielniak
- Physiotherapy Department, Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
- Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, 48-340 Glucholazy, Poland
| | - Alina Woźniak
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
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Kim YJ, Shin JS, Lee KW, Eom HJ, Jo BG, Lee JW, Kim JH, Kim SY, Kang JH, Choi JW. Expression, Purification, and Characterization of Plasmodium vivax Lactate Dehydrogenase from Bacteria without Codon Optimization. Int J Mol Sci 2023; 24:11083. [PMID: 37446261 DOI: 10.3390/ijms241311083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Plasmodium vivax is the most widespread cause of malaria, especially in subtropical and temperate regions such as Asia-Pacific and America. P. vivax lactate dehydrogenase (PvLDH), an essential enzyme in the glycolytic pathway, is required for the development and reproduction of the parasite. Thus, LDH from these parasites has garnered attention as a diagnostic biomarker for malaria and as a potential molecular target for developing antimalarial drugs. In this study, we prepared a transformed Escherichia coli strain for the overexpression of PvLDH without codon optimization. We introduced this recombinant plasmid DNA prepared by insertion of the PvLDH gene in the pET-21a(+) expression vector, into the Rosetta(DE3), an E. coli strain suitable for eukaryotic protein expression. The time, temperature, and inducer concentration for PvLDH expression from this E. coli Rosetta(DE3), containing the original PvLDH gene, were optimized. We obtained PvLDH with a 31.0 mg/L yield and high purity (>95%) from this Rosetta(DE3) strain. The purified protein was characterized structurally and functionally. The PvLDH expressed and purified from transformed bacteria without codon optimization was successfully demonstrated to exhibit its potential tetramer structure and enzyme activity. These findings are expected to provide valuable insights for research on infectious diseases, metabolism, diagnostics, and therapeutics for malaria caused by P. vivax.
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Affiliation(s)
- Yeon-Jun Kim
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Jun-Seop Shin
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Kang Woo Lee
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Hyo-Ji Eom
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Byung Gwan Jo
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
| | - Jin Woo Lee
- College of Pharmacy, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Jun Hyoung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea
| | - So Yeon Kim
- Department of Dental Hygiene, Cheongju University, Cheongju 28503, Republic of Korea
| | - Jung Hoon Kang
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
| | - Jae-Won Choi
- Department of Biomedical Science, Cheongju University, Cheongju 28160, Republic of Korea
- Department of Biopharmaceutical Sciences, Cheongju University, Cheongju 28160, Republic of Korea
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Nema S, Krishna S, Tiwari A, Bharti PK. Limited genetic diversity and expression profile of Plasmodium falciparum haem detoxification protein: a possible diagnostic target. Trans R Soc Trop Med Hyg 2022; 116:1162-1171. [PMID: 35724244 DOI: 10.1093/trstmh/trac055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/11/2022] [Accepted: 05/21/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Haem detoxification protein (HDP) is a significant protein in the erythrocytic stage of the Plasmodium lifecycle. HDP could be of paramount interest as a diagnostic biomarker for accurate diagnosis of malaria. We thus explored HDP genetic variation, expression levels of HDP and immune response. METHODS Phylogenetic analysis was carried out using Pfhdp orthologues sequences of various Plasmodium species. Blood samples were collected from patients in central India. Pfhdp gene was amplified, and sequenced by sanger DNA sequencing. B-cell epitopes were identified in PfHDP using Bepipred Linear Epitope Prediction 2.0, and median-joining network was constructed using global PfHDP sequences. Pfhdp expression levels during erythrocytic stage were assessed using real-time qPCR at 4-h intervals. An IgG immune response against synthetic PfHDP peptides was analysed using ELISA. RESULTS Phylogenetic analysis revealed the conserved nature of Pfhdp gene. Diversity analysis revealed one non-synonymous mutation (F91L) among all isolates. Neutrality tests indicated negative selection for Pfhdp gene. HDP was expressed throughout the erythrocytic cycle, and comparatively, high expression was observed in the late trophozoite and schizont stages. High IgG response against both peptides was observed, and no polymorphism was seen in any of the seven predicted B-cell epitopes. CONCLUSIONS Findings of the present study indicate the possibility of HDP being exploited as a diagnostic biomarker for Plasmodium falciparum malaria after proteomic validation studies.
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Affiliation(s)
- Shrikant Nema
- Division of Vector-Borne Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur 482 003, Madhya Pradesh, India.,School of Biotechnology, Rajiv Gandhi Proudyogiki Vishwavidyalaya (State Technological University of Madhya Pradesh), Bhopal, 462 023, Madhya Pradesh, India
| | - Sri Krishna
- Division of Vector-Borne Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur 482 003, Madhya Pradesh, India
| | - Archana Tiwari
- School of Biotechnology, Rajiv Gandhi Proudyogiki Vishwavidyalaya (State Technological University of Madhya Pradesh), Bhopal, 462 023, Madhya Pradesh, India
| | - Praveen Kumar Bharti
- Division of Vector-Borne Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur 482 003, Madhya Pradesh, India
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Kim YJ, Choi JW. Enzyme-linked aptamer-based sandwich assay (ELASA) for detecting Plasmodium falciparum lactate dehydrogenase, a malarial biomarker. RSC Adv 2022; 12:29535-29542. [PMID: 36320752 PMCID: PMC9562052 DOI: 10.1039/d2ra03796c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/08/2022] [Indexed: 01/24/2023] Open
Abstract
Herein, we report a sensitive and selective enzyme-linked aptamer-based sandwich assay (ELASA) to detect Plasmodium falciparum lactate dehydrogenase (PfLDH), which is an attractive biomarker for malaria diagnosis and antimalarial medication. We performed the sandwich assay with a single aptamer sequence, called 2008s, owing to the structural properties of the PfLDH tetramer instead of using a conventional sandwich assay with two different aptamers (or antibodies) for capturing and probing a target molecule. First, the biotinylated PfLDH aptamer was linked with immobilized streptavidin on a microwell plate for binding flexibility, and then PfLDH was bound to the aptamer. Next, a horseradish peroxidase-conjugated aptamer of the same sequence was used to analyze PfLDH quantitatively. Using this approach, the limit of detection (LOD) of PfLDH with the naked eye was 100 ng mL-1, and the LOD and limit of quantification from the absorbance measurements were 34.9 ng mL-1 and 95.5 ng mL-1, respectively, based on PfLDH spiked blood samples. Our proposed method selectively binds PfLDH, not human lactate dehydrogenase. Therefore, this method may be a valuable tool for diagnosing, monitoring, and quarantining malaria cases easily and rapidly.
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Affiliation(s)
- Yeon-Jun Kim
- Department of Biomedical Science, Cheongju UniversityCheongju 28160Republic of Korea
| | - Jae-Won Choi
- Department of Biomedical Science, Cheongju UniversityCheongju 28160Republic of Korea,Department of Bioindustrial EngineeringCheongju 28503Republic of Korea
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Antibody Responses Against Plasmodium falciparum MSP3 Protein During Natural Malaria Infection in Individuals Living in Malaria-Endemic Regions of India. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, INDIA SECTION B: BIOLOGICAL SCIENCES 2022; 92:613-619. [PMID: 35411125 PMCID: PMC8985746 DOI: 10.1007/s40011-021-01330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/04/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022]
Abstract
The humoral immune responses to blood-stage malaria proteins are requisite for the inhibition of parasite invasion. Plasmodium falciparum merozoite surface protein 3 (MSP3) is a secretory, expressed abundantly, merozoite surface protein that is important for the parasite invasion process. It has been shown to induce antibody responses during natural infections and is, therefore, considered to be the potential vaccine candidates against Plasmodium. Elucidating the immunogenicity and prevalence of anti-parasite antibodies is important in identifying potential targets as candidates for malarial diagnosis and anti‐malarial vaccine. The present study concerns the presence of antibodies against the MSP3 proteins of human malaria parasite- P. falciparum in infected individuals from endemic regions of India. Seventy-one anonymized P. falciparum infected serum samples were procured from the malaria fever clinic of ICMR-National Institute of Malaria Research (NIMR), New Delhi to detect the presence of antibodies against MSP3 protein by ELISA. The IgM antibody response against recombinant MSP3 was detected at significantly higher levels during acute malaria. The protein was found to be immunogenic and did not demonstrate any cross-reactivity with the serum of uninfected individuals or individuals infected with other Plasmodium species. The protein has hydrophilic regions in its N- and C-terminus which may contain immunogenic linear and conformational B-cell epitopes. The results from this study suggest that the MSP3 is immunogenic and likely a potential candidate for antibody-based diagnosis or vaccine development against the blood-stage of P. falciparum.
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Brilhante-da-Silva N, do Nascimento Martinez L, de Oliveira Sousa RM, dos Santos Pereira S, Teles CBG. Innovations in Plasmodium spp . diagnosis on diverse detection platforms. 3 Biotech 2021; 11:505. [PMID: 34881167 DOI: 10.1007/s13205-021-03054-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
In 2019, 229 million cases of malaria were recorded worldwide. For epidemiologic surveillance and proper treatment of persons infected with Plasmodium spp., rapid detection of infections by Plasmodium spp. is critical. Thus, Plasmodium spp. diagnosis is one of the indispensable measures for malaria control. Although microscopy is the gold standard for diagnosis, it has restrictions related mainly to the lack of qualified human resources, which is a problem in many regions. Thus, this review presents major innovations in diagnostic methods as alternatives to or complementary to microscopy. Detection platforms in lateral flow systems, electrochemical immunosensors, molecular biology and, more recently, those integrated with smartphones, are highlighted, among others. The advanced improvement of these tests aims to provide techniques that are sensitive and specific, but also quick, easy to handle and free from the laboratory environment. In this way, the tracking of malaria cases can become increasingly effective and contribute to controlling the disease.
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Kojom Foko LP, Pande V, Singh V. Field Performances of Rapid Diagnostic Tests Detecting Human Plasmodium Species: A Systematic Review and Meta-Analysis in India, 1990-2020. Diagnostics (Basel) 2021; 11:590. [PMID: 33806066 PMCID: PMC8064471 DOI: 10.3390/diagnostics11040590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 11/29/2022] Open
Abstract
Rapid diagnostic tests (RDTs) have become a mainstay of malaria diagnosis in endemic countries since their implementation in the 1990s. We conducted a 30-year systematic review and meta-analysis on malaria RDTs performance in India. Outcomes of interest were sensitivity (Se), specificity (Sp), positive/negative likelihood ratio (PLR/NLR), and diagnostic odd ratio (DOR). Among the 75 studies included, most of the studies were cross-sectional (65.3%), hospital-based (77.3%), and targeted febrile patients (90.6%). Nearly half of RDTs were designed for detecting Plasmodium falciparum only (47.5%) while the rest were for P. falciparum and P. vivax (11.9%), and P. falciparum/Pan-Plasmodium except for P. knowlesi (32.3%). When compared to light microscopy (gold standard), pooled estimates of performances were: Se = 97.0%, Sp = 96.0%, PLR = 22.4, NLR = 0.02 and DOR = 1080. In comparison to polymerase chain reaction, the RDTs showed Se = 89.0% and Sp = 99.0%. Performance outcomes (Se and Sp) were similar for RDT targeting P. falciparum only, but decreased for mixed and non-falciparum infections. Performances of malaria RDTs are still high India. However, there is a need for developing RDTs with regard to targeting minor malarial species, individuals carrying only mature gametocytes, and pfhrp2-deleted parasites.
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Affiliation(s)
- Loick Pradel Kojom Foko
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi 110077, India;
- Department of Biotechnology, Kumaun University, Bhimtal, Uttarakhand 263001, India;
| | - Veena Pande
- Department of Biotechnology, Kumaun University, Bhimtal, Uttarakhand 263001, India;
| | - Vineeta Singh
- Cell Biology Laboratory and Malaria Parasite Bank, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi 110077, India;
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