1
|
Prieto-Torres AE, Katime Zuñiga A, Lacouture Ortiz B, Faccini-Martínez ÁA. False Positive for Malaria Rapid Test in a Patient With Cytomegalovirus Infection. Cureus 2024; 16:e63896. [PMID: 39104966 PMCID: PMC11298326 DOI: 10.7759/cureus.63896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
There is a growing development of immunochromatographic tests for the detection of specific Plasmodium spp. antigens. These tests rely on capturing antigens from peripheral blood using monoclonal or polyclonal antibodies against specific targets. We present the case of a 28-year-old male patient with a history of two previous episodes of Plasmodium falciparum malaria, treated appropriately seven months and three years ago. He was referred to our institution with a six-day history of fever, epigastric pain, hematuria, and vomiting. Serial thick and thin blood smears were negative for hemoparasites, but a Bioline™ Malaria Ag P.f/Pan rapid test was positive for the Pan (pLDH) band. Given the clinical context and inability to visualize Plasmodium in blood smears, the positive pLDH band on the rapid malaria test was considered a possible false positive. Subsequent tests concluded that the patient was experiencing a cytomegalovirus (CMV) infection, which improved with supportive management, and he was discharged symptom-free. Malaria remains a major public health issue in tropical and subtropical regions. While rapid diagnostic tests are crucial for timely diagnosis, false positives due to cross-reactivity with other infections and conditions are reported. Our case highlights the potential for cross-reactivity with CMV infections, although direct evidence of active viral replication was not obtained. This phenomenon can lead to the overestimation of malaria cases and inappropriate treatment, underscoring the need for careful interpretation of rapid test results.
Collapse
Affiliation(s)
| | | | | | - Álvaro A Faccini-Martínez
- Infectious Disease Service, Hospital Militar Central, Bogotá, COL
- Faculty of Medicine, Universidad Militar Nueva Granada, Bogotá, COL
- Services and Consulting in Infectology, Infectious Disease Service, Bogotá, COL
| |
Collapse
|
2
|
Ma T, Huang K, Cheng N. Recent Advances in Nanozyme-Mediated Strategies for Pathogen Detection and Control. Int J Mol Sci 2023; 24:13342. [PMID: 37686145 PMCID: PMC10487713 DOI: 10.3390/ijms241713342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/13/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Pathogen detection and control have long presented formidable challenges in the domains of medicine and public health. This review paper underscores the potential of nanozymes as emerging bio-mimetic enzymes that hold promise in effectively tackling these challenges. The key features and advantages of nanozymes are introduced, encompassing their comparable catalytic activity to natural enzymes, enhanced stability and reliability, cost effectiveness, and straightforward preparation methods. Subsequently, the paper delves into the detailed utilization of nanozymes for pathogen detection. This includes their application as biosensors, facilitating rapid and sensitive identification of diverse pathogens, including bacteria, viruses, and plasmodium. Furthermore, the paper explores strategies employing nanozymes for pathogen control, such as the regulation of reactive oxygen species (ROS), HOBr/Cl regulation, and clearance of extracellular DNA to impede pathogen growth and transmission. The review underscores the vast potential of nanozymes in pathogen detection and control through numerous specific examples and case studies. The authors highlight the efficiency, rapidity, and specificity of pathogen detection achieved with nanozymes, employing various strategies. They also demonstrate the feasibility of nanozymes in hindering pathogen growth and transmission. These innovative approaches employing nanozymes are projected to provide novel options for early disease diagnoses, treatment, and prevention. Through a comprehensive discourse on the characteristics and advantages of nanozymes, as well as diverse application approaches, this paper serves as a crucial reference and guide for further research and development in nanozyme technology. The expectation is that such advancements will significantly contribute to enhancing disease control measures and improving public health outcomes.
Collapse
Affiliation(s)
- Tianyi Ma
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (T.M.); (K.H.)
| | - Kunlun Huang
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (T.M.); (K.H.)
- Key Laboratory of Safety Assessment of Genetically Modified Organism (Food Safety), Ministry of Agriculture, Beijing 100083, China
| | - Nan Cheng
- Beijing Laboratory for Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China; (T.M.); (K.H.)
- Key Laboratory of Safety Assessment of Genetically Modified Organism (Food Safety), Ministry of Agriculture, Beijing 100083, China
| |
Collapse
|
3
|
Fikadu M, Ashenafi E. Malaria: An Overview. Infect Drug Resist 2023; 16:3339-3347. [PMID: 37274361 PMCID: PMC10237628 DOI: 10.2147/idr.s405668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Malaria is a global public health burden with an estimated 229 million cases reported worldwide in 2019. About 94% of the reported cases were recorded in the African region. About 200 different species of protozoa have been identified so far and among them, at least 13 species are known to be pathogenic to humans. The life cycle of the malaria parasite is a complex process comprising an Anopheles mosquito and a vertebrate host. Its pathophysiology is characterized by fever secondary to the rupture of erythrocytes, macrophage ingestion of merozoites, and/or the presence of antigen-presenting trophozoites in the circulation or spleen which mediates the release of tumor necrosis factor α (TNF-α). Malaria can be diagnosed through clinical observation of the signs and symptoms of the disease. Other diagnostic techniques used to diagnose malaria are the microscopic detection of parasites from blood smears and antigen-based rapid diagnostic tests. The management of malaria involves preventive and/or curative approaches. Since untreated uncomplicated malaria can progress to severe malaria. To prevent or delay the spread of antimalarial drug resistance, WHO recommends the use of combination therapy for all episodes of malaria with at least two effective antimalarial agents having a different mechanism of action. The Centers for Disease Control (CDC) emphasizes that there is no prophylactic agent that can prevent malaria 100%. Therefore, prophylaxis shall be augmented with the use of personal protective measures.
Collapse
Affiliation(s)
- Muluemebet Fikadu
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ephrem Ashenafi
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
4
|
Okanda D, Ndwiga L, Osoti V, Achieng N, Wambua J, Ngetsa C, Lubell-Doughtie P, Shankar A, Bejon P, Ochola-Oyier LI. Low frequency of Plasmodium falciparum hrp2/3 deletions from symptomatic infections at a primary healthcare facility in Kilifi, Kenya. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1083114. [PMID: 38455911 PMCID: PMC10910971 DOI: 10.3389/fepid.2023.1083114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/23/2023] [Indexed: 03/09/2024]
Abstract
There is a growing concern for malaria control in the Horn of Africa region due to the spread and rise in the frequency of Plasmodium falciparum Histidine-rich Protein (hrp) 2 and 3 deletions. Parasites containing these gene deletions escape detection by the major PfHRP2-based rapid diagnostic test. In this study, the presence of Pfhrp2/3 deletions was examined in uncomplicated malaria patients in Kilifi County, from a region of moderate-high malaria transmission. 345 samples were collected from the Pingilikani dispensary in 2019/2020 during routine malaria care for patients attending this primary health care facility. The Carestart™ RDT and microscopy were used to test for malaria. In addition, qPCR was used to confirm the presence of parasites. In total, 249 individuals tested positive for malaria by RDT, 242 by qPCR, and 170 by microscopy. 11 samples that were RDT-negative and microscopy positive and 25 samples that were qPCR-positive and RDT-negative were considered false negative tests and were examined further for Pfhrp2/3 deletions. Pfhrp2/3-negative PCR samples were further genotyped at the dihydrofolate reductase (Pfdhfr) gene which served to further confirm that parasite DNA was present in the samples. The 242 qPCR-positive samples (confirmed the presence of DNA) were also selected for Pfhrp2/3 genotyping. To determine the frequency of false negative results in low parasitemia samples, the RDT- and qPCR-negative samples were genotyped for Pfdhfr before testing for Pfhrp2/3. There were no Pfhrp2 and Pfhrp3 negative but positive for dhfr parasites in the 11 (RDT negative and microscopy positive) and 25 samples (qPCR-positive and RDT-negative). In the larger qPCR-positive sample set, only 5 samples (2.1%) were negative for both hrp2 and hrp3, but positive for dhfr. Of the 5 samples, there were 4 with more than 100 parasites/µl, suggesting true hrp2/3 deletions. These findings revealed that there is currently a low prevalence of Pfhrp2 and Pfhrp3 deletions in the health facility in Kilifi. However, routine monitoring in other primary health care facilities across the different malaria endemicities in Kenya is urgently required to ensure appropriate use of malaria RDTs.
Collapse
Affiliation(s)
- Dorcas Okanda
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Leonard Ndwiga
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Victor Osoti
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Nicole Achieng
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Juliana Wambua
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Caroline Ngetsa
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Anuraj Shankar
- Nuffield Department of Medicine, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Philip Bejon
- Biosciences Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | | |
Collapse
|
5
|
Maturana CR, de Oliveira AD, Nadal S, Bilalli B, Serrat FZ, Soley ME, Igual ES, Bosch M, Lluch AV, Abelló A, López-Codina D, Suñé TP, Clols ES, Joseph-Munné J. Advances and challenges in automated malaria diagnosis using digital microscopy imaging with artificial intelligence tools: A review. Front Microbiol 2022; 13:1006659. [PMID: 36458185 PMCID: PMC9705958 DOI: 10.3389/fmicb.2022.1006659] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/26/2022] [Indexed: 09/03/2023] Open
Abstract
Malaria is an infectious disease caused by parasites of the genus Plasmodium spp. It is transmitted to humans by the bite of an infected female Anopheles mosquito. It is the most common disease in resource-poor settings, with 241 million malaria cases reported in 2020 according to the World Health Organization. Optical microscopy examination of blood smears is the gold standard technique for malaria diagnosis; however, it is a time-consuming method and a well-trained microscopist is needed to perform the microbiological diagnosis. New techniques based on digital imaging analysis by deep learning and artificial intelligence methods are a challenging alternative tool for the diagnosis of infectious diseases. In particular, systems based on Convolutional Neural Networks for image detection of the malaria parasites emulate the microscopy visualization of an expert. Microscope automation provides a fast and low-cost diagnosis, requiring less supervision. Smartphones are a suitable option for microscopic diagnosis, allowing image capture and software identification of parasites. In addition, image analysis techniques could be a fast and optimal solution for the diagnosis of malaria, tuberculosis, or Neglected Tropical Diseases in endemic areas with low resources. The implementation of automated diagnosis by using smartphone applications and new digital imaging technologies in low-income areas is a challenge to achieve. Moreover, automating the movement of the microscope slide and image autofocusing of the samples by hardware implementation would systemize the procedure. These new diagnostic tools would join the global effort to fight against pandemic malaria and other infectious and poverty-related diseases.
Collapse
Affiliation(s)
- Carles Rubio Maturana
- Microbiology Department, Vall d’Hebron Research Institute, Vall d’Hebron Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Allisson Dantas de Oliveira
- Computational Biology and Complex Systems Group, Physics Department, Universitat Politècnica de Catalunya (UPC), Castelldefels, Spain
| | - Sergi Nadal
- Data Base Technologies and Information Group, Engineering Services and Information Systems Department, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Besim Bilalli
- Data Base Technologies and Information Group, Engineering Services and Information Systems Department, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Francesc Zarzuela Serrat
- Microbiology Department, Vall d’Hebron Research Institute, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - Mateu Espasa Soley
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Clinical Laboratories, Microbiology Department, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Elena Sulleiro Igual
- Microbiology Department, Vall d’Hebron Research Institute, Vall d’Hebron Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBERINFEC, ISCIII- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Alberto Abelló
- Data Base Technologies and Information Group, Engineering Services and Information Systems Department, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Daniel López-Codina
- Computational Biology and Complex Systems Group, Physics Department, Universitat Politècnica de Catalunya (UPC), Castelldefels, Spain
| | - Tomàs Pumarola Suñé
- Microbiology Department, Vall d’Hebron Research Institute, Vall d’Hebron Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Elisa Sayrol Clols
- Image Processing Group, Telecommunications and Signal Theory Group, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Joan Joseph-Munné
- Microbiology Department, Vall d’Hebron Research Institute, Vall d’Hebron Hospital Campus, Barcelona, Spain
| |
Collapse
|
6
|
Nicklen FD, Diaz AJ, Lu J, Patel ST, Zheng EM, Campbell VR, Wu BM, Kamei DT. Application of the aqueous two-phase system and nanozyme signal enhancement for the improved detection of Plasmodium lactate dehydrogenase in serum. Anal Bioanal Chem 2022; 414:7949-7956. [PMID: 36169675 DOI: 10.1007/s00216-022-04346-3] [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: 06/29/2022] [Revised: 09/03/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022]
Abstract
Malaria is an infectious disease that can cause severe sickness and death if not diagnosed and treated in a timely manner. The current gold standard technique for malaria diagnosis is microscopy, which requires a dedicated laboratory setting and trained personnel and can have a long time to result. These requirements can be alleviated using paper-based diagnostic devices that enable rapid and inexpensive diagnosis at the point of care, which can allow patients to receive treatment before their symptoms progress when used for early detection of diseases. The lateral-flow immunoassay (LFA) is one such device, but currently available LFAs are susceptible to false negative results caused by low parasite density. To improve sensitivity and detection, we utilized the aqueous two-phase system (ATPS) to concentrate and purify the sample, and nanozyme signal enhancement to increase the intensity of the visible signal on the test strip. We were able to achieve a limit of detection (LOD) of 0.01 ng/mL for the malaria biomarker Plasmodium lactate dehydrogenase (pLDH) in human serum using a multi-step assay combining the LFA format with the ATPS and nanozyme signal enhancement.
Collapse
Affiliation(s)
- Frances D Nicklen
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Alexia J Diaz
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Jiakun Lu
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Salil T Patel
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Elaine M Zheng
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Veronica R Campbell
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA
| | - Benjamin M Wu
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA.,Division of Advanced Prosthodontics & Weintraub Center for Reconstructive Biotechnology, School of Dentistry, University of California, Los Angeles, CA, 90095, USA
| | - Daniel T Kamei
- Department of Bioengineering, University of California, Los Angeles, CA, 90095, USA.
| |
Collapse
|
7
|
Classification of Malaria Using Object Detection Models. INFORMATICS 2022. [DOI: 10.3390/informatics9040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Malaria poses a global health problem every day, as it affects millions of lives all over the world. A traditional diagnosis requires the manual inspection of blood smears from the patient under a microscope to check for the malaria parasite. This is often time consuming and subject to error. Thus, the automated detection and classification of the malaria type and stage of progression can provide a quicker and more accurate diagnosis for patients. In this research, we used two object detection models, YOLOv5 and scaled YOLOv4, to classify the stage of progression and type of malaria parasite. We also used two different datasets for the classification of stage and parasite type while assessing the viability of the dataset for the task. The dataset used is comprised of microscopic images of red blood cells that were either parasitized or uninfected. The infected cells were classified based on two broad categories: the type of malarial parasite causing the infection and the stage of progression of the disease. The dataset was manually annotated using the LabelImg tool. The images were then augmented to enhance model training. Both models YOLOv5 and scaled YOLOv4 proved effective in classifying the type of parasite. Scaled YOLOv4 was in the lead with an accuracy of 83% followed by YOLOv5 with an accuracy of 78.5%. The proposed models may be useful for the medical professionals in the accurate diagnosis of malaria and its stage prediction.
Collapse
|
8
|
Cruz CJG, Kil R, Wong S, Dacquay LC, Mirano-Bascos D, Rivera PT, McMillen DR. Malarial Antibody Detection with an Engineered Yeast Agglutination Assay. ACS Synth Biol 2022; 11:2938-2946. [PMID: 35861604 DOI: 10.1021/acssynbio.2c00160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Malaria, a disease caused by the Plasmodium parasite carried by Anopheles mosquitoes, is commonly diagnosed by microscopy of peripheral blood smears and with rapid diagnostic tests. Both methods show limited detection of low parasitemia that may maintain transmission and hinder malaria elimination. We have developed a novel agglutination assay in which modified Saccharomyces cerevisiae cells act as antigen-displaying bead-like particles to capture malaria antibodies. The Epidermal Growth Factor-1 like domain (EGF1) of the Plasmodium falciparum merozoite surface protein-1 (PfMSP-119) was displayed on the yeast surface and shown to be capable of binding antimalaria antibodies. Mixed with a second yeast strain displaying the Z domain of Protein A from Staphylococcus aureus and allowed to settle in a round-bottomed well, the yeast produce a visually distinctive agglutination test result: a tight "button" at a low level of malarial antibodies, and a diffuse "sheet" when higher antibody levels are present. Positive agglutination results were observed in malaria-positive human serum to a serum dilution of 1:100 to 1:125. Since the yeast cells are inexpensive to produce, the test may be amenable to local production in regions seeking malaria surveillance information to guide their elimination programs.
Collapse
Affiliation(s)
- Criselda Jean G Cruz
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada.,College of Medicine, University of the Philippines Manila, Manila 1108, Philippines
| | - Richard Kil
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada.,Department of Chemistry, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - Stanley Wong
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada.,Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Louis C Dacquay
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada.,Department of Cell and Systems Biology, University of Toronto, Toronto, Ontario M5S 3G5, Canada
| | - Denise Mirano-Bascos
- National Institute of Molecular Biology and Biotechnology, University of the Philippines Diliman, Quezon City 1101, Philippines
| | - Pilarita T Rivera
- College of Medicine, University of the Philippines Manila, Manila 1108, Philippines.,Department of Parasitology, College of Public Health, University of the Philippines Manila, Manila 1000, Philippines
| | - David R McMillen
- Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6, Canada.,Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada.,Department of Cell and Systems Biology, University of Toronto, Toronto, Ontario M5S 3G5, Canada
| |
Collapse
|
9
|
Pasaribu AP, Nasution IS, Sembiring K, Fahmi F, Pasaribu S. Comparison of the performance of the CareStart Malaria Pf/Pan Combo test and field microscopy in the diagnosis of Plasmodium vivax malaria in North Sumatera, Indonesia. Malar J 2022; 21:27. [PMID: 35093067 PMCID: PMC8800299 DOI: 10.1186/s12936-022-04057-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 01/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background In areas where malaria is endemic and where trained microscopists are not available, rapid diagnostic tests (RDTs) are needed not only to allow prompt treatment without delay but also to prevent overdiagnosis and overtreatment based on clinical judgements that may lead to drug resistance. This study aimed to compare the performances of the CareStart Pf/Pan Combo test to field microscopy, which is considered to be the gold standard for malaria diagnosis. Methods Any person with a fever or a history of fever within 48 h who came to the health centre was recruited for the study and tested both by the CareStart Pf/Pan test and by field microscopy. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were analysed with both methods. Results Two-hundred study participants were enrolled: 96 (48%) were found to be positive through microscopy, while 100 (50%) participants were found to be positive through RDT. The RDT produced four false-positive results. High sensitivity and specificity were observed for the CareStart Pf/Pan test (100 and 96.15%, respectively). The CareStart Pf/Pan test also showed excellent agreement with the field microscopy results. Conclusion The Carestart Pf/Pan could be used as an alternative diagnostic test in malaria-endemic areas where facility for performing microscopy is not available.
Collapse
|
10
|
Wangmaung N, Chomean S, Ittarat W. Differential diagnosis of Plasmodium falciparum and Plasmodium vivax in mixed infection by colorimetric nanogold probes. Anal Biochem 2021; 624:114173. [PMID: 33757758 DOI: 10.1016/j.ab.2021.114173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/18/2022]
Abstract
Malaria is an infectious disease reported mostly in the tropical region. The most severe human malaria is Plasmodium falciparum since it can cause cerebral malaria. Therefore, the presence of P. falciparum either in single or mixed infection needs accurate diagnosis. In some mixed infections, the presence of P. falciparum may be cryptic which cannot be detected by microscopic examination. The molecular diagnosis is required in these cases. Many methods based on amplification of malaria parasite genes have been developed but most of them need sophisticated instruments. Here, we created a colorimetric method using probe immobilized gold nanoparticles (AuNPs) to detect the malaria parasite gene. Color changes rely on salt-induced aggregation of AuNPs in the presence or absence of DNA hybridization. Color changes could be observed either by a naked eye or UV-vis spectrophotometer. By this approach, single infection by the most common malaria parasite, P. falciparum or P. vivax could be differentially identified. Mixed infection of these two malaria species could also be clearly diagnosed including cases of cryptic P. falciparum. The novel nanogold based molecular malaria diagnosis is sensitive, specific, rapid and cheap ($0.94). The prepared nanogold malaria probes are stable for up to 3 months indicating their filed application in remote areas.
Collapse
Affiliation(s)
- Nantawan Wangmaung
- Medical Technology, Schools of Allied Health Science, Walailak University, Thailand.
| | - Sirinart Chomean
- Medical Technology, Faculty of Allied Health Science, Thammasat University, Thailand
| | - Wanida Ittarat
- Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Thailand
| |
Collapse
|
11
|
Kumar V, Ray S, Aggarwal S, Biswas D, Jadhav M, Yadav R, Sabnis SV, Banerjee S, Talukdar A, Kochar SK, Shetty S, Sehgal K, Patankar S, Srivastava S. Multiplexed quantitative proteomics provides mechanistic cues for malaria severity and complexity. Commun Biol 2020; 3:683. [PMID: 33204009 PMCID: PMC7672109 DOI: 10.1038/s42003-020-01384-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022] Open
Abstract
Management of severe malaria remains a critical global challenge. In this study, using a multiplexed quantitative proteomics pipeline we systematically investigated the plasma proteome alterations in non-severe and severe malaria patients. We identified a few parasite proteins in severe malaria patients, which could be promising from a diagnostic perspective. Further, from host proteome analysis we observed substantial modulations in many crucial physiological pathways, including lipid metabolism, cytokine signaling, complement, and coagulation cascades in severe malaria. We propose that severe manifestations of malaria are possibly underpinned by modulations of the host physiology and defense machinery, which is evidently reflected in the plasma proteome alterations. Importantly, we identified multiple blood markers that can effectively define different complications of severe falciparum malaria, including cerebral syndromes and severe anemia. The ability of our identified blood markers to distinguish different severe complications of malaria may aid in developing new clinical tests for monitoring malaria severity.
Collapse
Affiliation(s)
- Vipin Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sandipan Ray
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Shalini Aggarwal
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Deeptarup Biswas
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Manali Jadhav
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Radha Yadav
- Department of Mathematics, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sanjeev V Sabnis
- Department of Mathematics, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Soumaditya Banerjee
- Medicine Department, Medical College Hospital Kolkata, 88, College Street, Kolkata, 700073, India
| | - Arunansu Talukdar
- Medicine Department, Medical College Hospital Kolkata, 88, College Street, Kolkata, 700073, India
| | - Sanjay K Kochar
- Department of Medicine, Malaria Research Centre, S.P. Medical College, Bikaner, 334003, India
| | - Suvin Shetty
- Dr. L H Hiranandani Hospital, Mumbai, 400076, India
| | | | - Swati Patankar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - Sanjeeva Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, 400076, India.
| |
Collapse
|
12
|
Mallepaddi PC, Maity SN, Poonati R, Pyadala N, Polavarapu R, Mangamuri UK, Poda S. Selecting better diagnostic kits for diagnosis of malarial parasites at point of care. 3 Biotech 2019; 9:36. [PMID: 30622874 DOI: 10.1007/s13205-018-1566-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 12/31/2018] [Indexed: 10/27/2022] Open
Abstract
Malaria is a fatal life-threatening parasitic infection and a leading cause of morbidity and mortality. The present study was aimed to evaluate simple, inexpensive, accurate, reliable, easily available better diagnostic for rapid detection of malaria at point of care (POC). The study includes 1403 samples collected from the patients, of which 1227 were clinically suspected cases and 176 from consecutive feverish patients. Among the suspected cases only 338 samples were confirmed positive and 889 samples were negative for Plasmodium species by PCR. All the 889 samples showed negative result for plasmodium species by microscopy, Malarial Ag rapid kits but only 867 samples were confirmed negative with malarial Ab rapid kits. Of the 338 PCR positive samples, 337 samples were confirmed positive by microscopy and Malarial Ag rapid kits, but only 284 samples were confirmed positive using malarial Ab rapid kits. Overall the microscopy and the malaria antigen-based lateral flow assay exhibited similar sensitivity, specificity, PPV, NPV and efficiency, respectively, whereas the PCR assay had 100% sensitivity, specificity, PPV, NPV and efficiency. But the evolutionary data for malaria antibody lateral flow assay has 92.81% sensitivity, 94.13% specificity, 84.02% PPV, 97.52% NPV and 93.80% efficiency. The developed Malaria pf/pv antigen and antibody field-deployable kits are simple, rapid, accurate, reliable, inexpensive, user friendly, POC. In addition the kits are highly sensitive and species-specific. The pf/pv antigen kit is found to be more accurate with 99.7% sensitivity and 100% specificity than to Malaria pf/pv antibody rapid kits. Of the two rapid kits developed, Malaria pf/pv antigen kit is found be more accurate with 99.7% sensitivity and 100% specificity than to Malaria pf/pv antibody rapid kits.
Collapse
|
13
|
Adebisi NA, Dada-Adegbola HO, Dairo MD, Ajayi IO, Ajumobi OO. Performance of malaria rapid diagnostic test in febrile under-five children at Oni Memorial Children's Hospital in Ibadan, Nigeria, 2016. Pan Afr Med J 2018; 30:242. [PMID: 30574261 PMCID: PMC6296676 DOI: 10.11604/pamj.2018.30.242.13268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/17/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The World Health Organization (WHO) recommends testing of suspected malaria cases before treatment. Malaria rapid diagnostic test (mRDT) has been recommended for this purpose in endemic countries where microscopy is not accessible. However, its diagnostic performance remains a concern in clinical settings. We assessed diagnostic performance of RDT among febrile under-five children (U5) presenting at Oni Memorial Children's Hospital, Ibadan (OMCH). METHODS A cross-sectional study was conducted among 370 febrile U5 attending OMCH February to May, 2016. We examined their finger prick blood samples for malaria parasitaemia using CareStartTM histidine rich protein II (HRP-2) RDT and microscopy. The sensitivity, specificity, positive and negative predictive values (PPV, NPV), false positive (FP), invalid rates (IR), likelihood ratio of positive and negative tests (LRP and LRN), were calculated. RESULTS Mean age of the children was 28.17 ± 15.59 months. Malaria prevalence was 21.6% and 15.1% by mRDT and microscopy, respectively. Sensitivity of CareStartTM HRP-2 RDT was 94.6% (95% confidence interval (CI): 84.2-98.6), specificity: 91.4% (CI: 87.6-94.2), PPV: 66.3% (CI: 54.7-76.2), NPV: 98.9% (CI: 96.8-99.7), FPR 6.5%, IR 8.1%, LRP:10.6 and LRN:0.1. CONCLUSION Diagnostic performance of CareStartTM used in the study met the ≥ 95% sensitivity at 100 parasites/µL recommended by WHO. This finding provides clinical evidence that testing before anti-malarial treatment as recommended by WHO will identify cases of malaria infection and reduce unnecessary use of drugs. Healthcare workers should be educated on diagnostic accuracy of mRDT and adhere to the WHO's test-treat strategy for anti-malaria therapy.
Collapse
Affiliation(s)
| | | | - Magbagbeola David Dairo
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
| | - IkeOluwapo Oyeneye Ajayi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
| | - Olufemi Olamide Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- African Field Epidemiology Network, Abuja, Nigeria
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| |
Collapse
|
14
|
Calderaro A, Piccolo G, Montecchini S, Buttrini M, Rossi S, Dell'Anna ML, De Remigis V, Arcangeletti MC, Chezzi C, De Conto F. High prevalence of malaria in a non-endemic setting: comparison of diagnostic tools and patient outcome during a four-year survey (2013-2017). Malar J 2018; 17:63. [PMID: 29402283 PMCID: PMC5800101 DOI: 10.1186/s12936-018-2218-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/30/2018] [Indexed: 11/18/2022] Open
Abstract
Background Malaria is no longer endemic in Italy since 1970 when the World Health Organization declared Italy malaria-free, but it is now the most commonly imported disease. The aim of the study was to analyse the trend of imported malaria cases in Parma, Italy, during January 2013–June 2017, reporting also the treatment and the outcome of cases, exploring the comparison of the three diagnostic tests used for malaria diagnosis: microscopy, immunochromatographic assay (ICT) (BinaxNOW®) and Real-time PCR assays detecting Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale curtisi, Plasmodium ovale wallikeri, and Plasmodium knowlesi. Results Of the 288 patients with suspected malaria, 87 were positive by microscopy: 73 P. falciparum, 2 P. vivax, 8 P. ovale, 1 P. vivax/P. ovale, 1 P. malariae and 2 Plasmodium sp. All samples were positive by ICT except 6. Plasmodial DNA was revealed in the 87 cases and in 2 additional cases showing P. falciparum-specific bands by ICT, as follows: 75 P. falciparum, 2 P. vivax, 6 P. ovale curtisi, 3 P. ovale wallikeri, 1 P. malariae, and 2 mixed infections. 72 patients were foreigners and 17 Italians travelling for tourism or business. The majority of these patients presented with fever at blood collection and did not have chemoprophylaxis. No fatal cases were observed and the drug mostly used was quinine observing a negative blood smear or a parasitaemia < 0.001% after 48–72 h’ therapy. Conclusions The study shows an update and a thorough analysis of imported malaria cases in the area of Parma during 4.5 years from the point of view of the total case management, clinical and diagnostic. The prevalence of malaria in such area in the considered period was especially due to immigrants mostly from Africa. Molecular methods were more sensitive and specific than microscopy and ICT, both detecting additional cases of P. falciparum malaria missed by microscopy and correctly identifying the Plasmodium species of medical interest. The data reported in this study may stimulate the clinicians in non-endemic areas to suspect malaria also in cases, where the most typical symptoms are absent, and the parasitologists to confirm the results of microscopy, remaining the reference method, with molecular methods to avoid misdiagnosis.
Collapse
Affiliation(s)
- Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Giovanna Piccolo
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Sara Montecchini
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Mirko Buttrini
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Sabina Rossi
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Maria Loretana Dell'Anna
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Valeria De Remigis
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | | | - Carlo Chezzi
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Flora De Conto
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| |
Collapse
|
15
|
Olafuyi O, Coleman M, Badhan RK. The application of physiologically based pharmacokinetic modelling to assess the impact of antiretroviral-mediated drug-drug interactions on piperaquine antimalarial therapy during pregnancy. Biopharm Drug Dispos 2017; 38:464-478. [DOI: 10.1002/bdd.2087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Olusola Olafuyi
- Aston Healthy Research Group, Aston Pharmacy School; Aston University; Birmingham B4 7ET UK
| | - Michael Coleman
- Aston Pharmacy School; Aston University; Birmingham B4 7ET UK
| | - Raj K.S. Badhan
- Aston Healthy Research Group, Aston Pharmacy School; Aston University; Birmingham B4 7ET UK
- Aston Pharmacy School; Aston University; Birmingham B4 7ET UK
| |
Collapse
|
16
|
Krampa FD, Aniweh Y, Awandare GA, Kanyong P. Recent Progress in the Development of Diagnostic Tests for Malaria. Diagnostics (Basel) 2017; 7:diagnostics7030054. [PMID: 28925968 PMCID: PMC5617953 DOI: 10.3390/diagnostics7030054] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 02/07/2023] Open
Abstract
The impact of malaria on global health has continually prompted the need to develop effective diagnostic strategies. In malaria endemic regions, routine diagnosis is hampered by technical and infrastructural challenges to laboratories. These laboratories lack standard facilities, expertise or diagnostic supplies; thus, therapy is administered based on clinical or self-diagnosis. There is the need for accurate diagnosis of malaria due to the continuous increase in the cost of medication, and the emergence and spread of drug resistant strains. However, the widely utilized Giemsa-stained microscopy and immunochromatographic tests for malaria are liable to several drawbacks, including inadequate sensitivity and false-positive outcomes. Alternative methods that offer improvements in performance are either expensive, have longer turnaround time or require a level of expertise that makes them unsuitable for point-of-care (POC) applications. These gaps necessitate exploration of more efficient detection techniques with the potential of POC applications, especially in resource-limited settings. This minireview discusses some of the recent trends and new approaches that are seeking to improve the clinical diagnosis of malaria.
Collapse
Affiliation(s)
- Francis D Krampa
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Accra, Ghana.
- Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Legon, Accra, Ghana.
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Accra, Ghana.
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Accra, Ghana.
- Department of Biochemistry, Cell & Molecular Biology, University of Ghana, Legon, Accra, Ghana.
| | - Prosper Kanyong
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Accra, Ghana.
- Nanotechnology & Integrated Bioengineering Centre, Ulster University, Jordanstown BT37 0QB, UK.
| |
Collapse
|
17
|
Ray S, Patel SK, Venkatesh A, Chatterjee G, Ansari NN, Gogtay NJ, Thatte UM, Gandhe P, Varma SG, Patankar S, Srivastava S. Quantitative Proteomics Analysis of Plasmodium vivax Induced Alterations in Human Serum during the Acute and Convalescent Phases of Infection. Sci Rep 2017; 7:4400. [PMID: 28667326 PMCID: PMC5493610 DOI: 10.1038/s41598-017-04447-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 05/15/2017] [Indexed: 12/23/2022] Open
Abstract
The radial distribution of Plasmodium vivax malaria burden has evoked enormous concern among the global research community. In this study, we have investigated the serum proteome alterations in non-severe vivax malaria patients before and during patient recuperation starting from the early febrile to the defervescence and convalescent stages of the infection. We have also performed an extensive quantitative proteomics analysis to compare the serum proteome profiles of vivax malaria patients with low (LPVM) and moderately-high (MPVM) parasitemia with healthy community controls. Interestingly, some of the serum proteins such as Serum amyloid A, Apolipoprotein A1, C-reactive protein, Titin and Haptoglobin, were found to be sequentially altered with respect to increased parasite counts. Analysis of a longitudinal cohort of malaria patients indicated reversible alterations in serum levels of some proteins such as Haptoglobin, Apolipoprotein E, Apolipoprotein A1, Carbonic anhydrase 1, and Hemoglobin subunit alpha upon treatment; however, the levels of a few other proteins did not return to the baseline even during the convalescent phase of the infection. Here we present the first comprehensive serum proteomics analysis of vivax malaria patients with different levels of parasitemia and during the acute and convalescent phases of the infection.
Collapse
Affiliation(s)
- Sandipan Ray
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India.,Department of Clinical Biochemistry, Metabolic Research Laboratories, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Sandip K Patel
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India
| | - Apoorva Venkatesh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India
| | - Gangadhar Chatterjee
- Dept of Biochemistry, Grant Govt Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, 400008, India
| | - Naziya N Ansari
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India
| | - Nithya J Gogtay
- Departments of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai, 400012, India
| | - Urmila M Thatte
- Departments of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai, 400012, India
| | - Prajakta Gandhe
- Departments of Clinical Pharmacology, Seth GS Medical College & KEM Hospital, Parel, Mumbai, 400012, India
| | - Santosh G Varma
- Dept of Biochemistry, Grant Govt Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, 400008, India
| | - Swati Patankar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India
| | - Sanjeeva Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, 400076, India.
| |
Collapse
|
18
|
Miguel-Oteo M, Jiram AI, Ta-Tang TH, Lanza M, Hisam S, Rubio JM. Nested multiplex PCR for identification and detection of human Plasmodium species including Plasmodium knowlesi. ASIAN PAC J TROP MED 2017; 10:299-304. [DOI: 10.1016/j.apjtm.2017.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/12/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022] Open
|
19
|
Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria. J Clin Microbiol 2016; 55:253-263. [PMID: 27847373 PMCID: PMC5228238 DOI: 10.1128/jcm.01431-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/24/2016] [Indexed: 11/26/2022] Open
Abstract
The need to expand malaria diagnosis capabilities alongside policy requirements for mandatory testing before treatment motivates exploration of noninvasive rapid diagnostic tests (RDTs). We report the outcome of the first cross-sectional, single-blind clinical performance evaluation of a urine malaria test (UMT) for diagnosis of Plasmodium falciparum malaria in febrile patients. Matched urine and finger-prick blood samples from participants ≥2 years of age with fever (axillary temperature of ≥37.5°C) or with a history of fever in the preceding 48 h were tested with UMT and microscopy (as the gold standard). BinaxNOW (Pf and Pan versions) blood RDTs were done to assess relative performance. Urinalysis and rheumatoid factor (RF) tests were conducted to evaluate possible interference. Diagnostic performance characteristics were computed at 95% confidence intervals (CIs). Of 1,800 participants screened, 1,691 were enrolled; of these 566 (34%) were febrile, and 1,125 (66%) were afebrile. Among enrolled participants, 341 (20%) tested positive by microscopy, 419 (25%) were positive by UMT, 676 (40%) were positive by BinaxNOW Pf, and 368 (22%) were positive by BinaxNow Pan. UMT sensitivity among febrile patients (for whom the test was indicated) was 85%, and specificity was 84%. Among febrile children ≤5 years of age, UMT sensitivity was 93%, and specificity was 83%. The area under the receiver-operator characteristic curve (AUC) of UMT (0.84) was not significantly different from that of BinaxNOW Pf (0.86) or of BinaxNOW Pan (0.87), indicating that the tests do not differ in overall performance. Gender, seasons, and RF did not impact UMT performance. Leukocytes, hematuria, and urobilinogen concentrations in urine were associated with lower UMT specificities. UMT performance was comparable to that of the BinaxNOW Pf/Pan tests, making UMT a promising tool to expand malaria testing in public and private health care settings where there are challenges to blood-based malaria diagnosis testing.
Collapse
|
20
|
Sahu SS, Gunasekaran K, Jambulingam P. Field performance of malaria rapid diagnostic test for the detection of Plasmodium falciparum infection in Odisha State, India. Indian J Med Res 2016; 142 Suppl:S52-8. [PMID: 26905242 PMCID: PMC4795347 DOI: 10.4103/0971-5916.176620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Rapid diagnostic tests (RDTs) have become an essential surveillance tool in the malaria control programme in India. The current study aimed to assess the performance of ParaHIT-f, a rapid test in diagnosis of Plasmodium falciparum infection through detecting its specific antigen, histidine rich protein 2 (PfHRP-2), in Odisha State, India. METHODS The study was undertaken in eight falciparum malaria endemic southern districts of Odisha State. Febrile patients included through active case detection, were diagnosed by Accredited Social Health Activists (ASHAs) for P. falciparum infection using the RDT, ParaHIT-f. The performance of ParaHIT-f was evaluated using microscopy as the gold standard. RESULTS A total of 1030 febrile patients were screened by both microscopy and the RDT for P. falciparum infection. The sensitivity of ParaHIT-f was 63.6% (95% CI: 56.0-70.6) and specificity was 98.9% (95% CI: 97.9-99.5), with positive and negative predictive values (PPV and NPV) of 92.6% (95% CI: 86.0-96.3) and 93.0% (95% CI: 91.0-94.5), respectively. When related to parasitaemia, the RDT sensitivity was 47.8% at the low parasitaemia of 4 to 40 parasites/µl of blood. INTERPRETATION & CONCLUSIONS The results showed that the performance of the RDT, ParaHIT-f, was not as sensitive as microscopy in detecting true falciparum infections; a high specificity presented a low frequency of false-positive RDT results. t0 he sensitivity of ParaHIT-f was around 60 per cent. It is, therefore, essential to improve the efficiency (sensitivity) of the kit so that the true falciparum infections will not be missed especially in areas where P. falciparum has been the predominant species causing cerebral malaria.
Collapse
Affiliation(s)
| | - K Gunasekaran
- Vector Control Research Centre (ICMR), Puducherry, India
| | | |
Collapse
|
21
|
Karim HMR, Bhattacharyya P, Kakati SD, Borah TJ, Yunus M. Scrub typhus masquerading as HELLP syndrome and puerperal sepsis in an asymptomatic malaria patient. Qatar Med J 2016; 2016:2. [PMID: 27413718 PMCID: PMC4928108 DOI: 10.5339/qmj.2016.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/15/2016] [Indexed: 11/13/2022] Open
Abstract
Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without fever, dehydration, hemorrhage and hemolysis may lead to low blood pressure. Presence of toxic granules and elevated band forms in such patients can even mimic sepsis. When such a patient is in the peripartum period, it creates a strong clinical dilemma for the physician especially in unbooked obstetric cases. We present such a case where a 26-year-old unbooked female presented on second postpartum day with severe anemia, altered sensorium, difficulty in breathing along with jaundice and gum bleeding without history of fever. Rapid diagnostic test for malaria was negative and no eschar was seen. These parameters suggested a diagnosis of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet) syndrome with or without puerperal sepsis. Subsequently she was diagnosed as having asymptomatic malaria and scrub typhus and responded to the treatment of it. The biochemical changes suggestive of HELLP syndrome also subsided. We present this case to emphasize the fact that mere absence of fever and eschar does not rule out scrub typhus. It should also be considered as a differential diagnosis in patients with symptoms and signs suggesting HELLP syndrome. Asymptomatic malaria can complicate case scenario towards puerperal sepsis by giving false toxic granules and band form in such situations.
Collapse
Affiliation(s)
- Habib Md. Reazaul Karim
- Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Science, Shillong, Meghalaya, India
| | | | | | | | | |
Collapse
|
22
|
Deraney RN, Mace CR, Rolland JP, Schonhorn JE. Multiplexed, Patterned-Paper Immunoassay for Detection of Malaria and Dengue Fever. Anal Chem 2016; 88:6161-5. [PMID: 27186893 DOI: 10.1021/acs.analchem.6b00854] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Multiplex assays detect the presence of more than one analyte in a sample. For diagnostic applications, multiplexed tests save healthcare providers time and resources by performing many assays in parallel, minimizing the amount of sample needed and improving the quality of information acquired regarding the health status of a patient. These advantages are of particular importance for those diseases that present with general, overlapping symptoms, which makes presumptive treatments inaccurate and may put the patient at risk. For example, malaria and dengue fever are febrile illnesses transmitted through mosquito bites, and these common features make it difficult to obtain an accurate diagnosis by symptoms alone. In this manuscript, we describe the development of a multiplexed, patterned paper immunoassay for the detection of biomarkers of malaria and dengue fever: malaria HRP2, malaria pLDH, and dengue NS1 type 2. In areas coendemic for malaria and dengue fever, this assay could be used as a rapid, point-of-care diagnostic to determine the cause of a fever of unknown origin. The reagents required for each paper-based immunoassay are separated spatially within a three-dimensional device architecture, which allows the experimental conditions to be adjusted independently for each assay. We demonstrate the analytical performances of paper-based assays for each biomarker and we show that there is no significant difference in performance between the multiplexed immunoassay and those immunoassays performed in singleplex. Additionally, we spiked individual analytes into lysed human blood to demonstrate specificity in a clinically relevant sample matrix. Our results suggest multiplex paper-based devices can be an essential component of diagnostic assays used at the point-of-care.
Collapse
Affiliation(s)
- Rachel N Deraney
- Diagnostics For All , 840 Memorial Drive, Cambridge, Massachusetts 02139, United States
| | - Charles R Mace
- Department of Chemistry, Tufts University , 62 Talbot Avenue, Medford, Massachusetts 02155, United States
| | - Jason P Rolland
- Diagnostics For All , 840 Memorial Drive, Cambridge, Massachusetts 02139, United States
| | - Jeremy E Schonhorn
- Diagnostics For All , 840 Memorial Drive, Cambridge, Massachusetts 02139, United States
| |
Collapse
|
23
|
Kamel MM, Attia SS, Emam GD, Al Sherbiny NAEK. The Validity of Rapid Malaria Test and Microscopy in Detecting Malaria in a Preelimination Region of Egypt. SCIENTIFICA 2016; 2016:4048032. [PMID: 27088038 PMCID: PMC4819100 DOI: 10.1155/2016/4048032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/09/2016] [Indexed: 05/07/2023]
Abstract
Background. Malaria is a leading cause of morbidity and mortality worldwide. Rapid and accurate diagnosis of malaria would improve control measures and reduce morbidity and mortality. Objective. The aim of this study was to assess the prevalence of malaria in high risk foci in Egypt and the effectiveness of rapid diagnostic tests in diagnosis and subsequently control of malaria. Methodology. A total number of 600 cases of both sexes with different ages were included in the present study. Cases were included in 2 groups; first group (500 cases) were randomly selected from households in Fayoum Governorate and second group (100 cases) were admitted to Fayoum Fever Hospital with signs suggestive of malaria. Cases were subjected to detailed history taking, clinical examination, microscopic examination of thin and thick blood films, and immunological test to detect plasmodial antigens. Results. A total of 3 positive cases were detected by rapid diagnostic tests (RDTs). Out of these 3 cases, one case was positive for malaria parasite by microscopic examination of blood films. All positive cases in the study had history of travel to malaria endemic areas. Conclusion. RDTs are simple and effective for rapid diagnosis of malaria to help in implication of control measures in different localities.
Collapse
Affiliation(s)
- Maysa Mohamed Kamel
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samar Sayed Attia
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gomaa Desoky Emam
- Medical Parasitology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | | |
Collapse
|
24
|
Oyeyemi OT, Sode OJ, Adebayo OD, Mensah-Agyei GO. Reliability of rapid diagnostic tests in diagnosing pregnancy and infant-associated malaria in Nigeria. J Infect Public Health 2015; 9:471-7. [PMID: 26738923 DOI: 10.1016/j.jiph.2015.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/31/2015] [Accepted: 11/10/2015] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The effective management of maternal and infant malaria requires rational and prompt diagnosis. This study aims to determine the diagnostic efficiency of malaria RDT in infants and pregnant women. METHODS The study was conducted on infants (n=200), pregnant women (n=80) and non-pregnant women (n=100) who were recruited from two hospitals in Lagos, Nigeria. Plasmodium falciparum infections were assessed in the febrile subjects by microscopic examinations of blood smears and by RDT. RESULTS The lowest (44.3%) and the highest (83.3%) sensitivity (SS) values were recorded in the infants and pregnant women, respectively. Other diagnostic parameters, including the specificity (SP, 97.5%), positive predictive value (PPV, 92.1%) and negative predictive value (NPV, 72.8%), in the infants were greater than the values recorded in non-pregnant (SP=77.5%, PPV=83.9%, NPV=70.5%) and pregnant women populations (SP=65.6%, PPV=78.4%, NPV=72.4%). The diagnostic efficiency of malaria RDT exhibited higher sensitivity in women in early gestational stages (1st trimester=78.6% and 2nd trimester=88.0%) compared with those in the 3rd trimester (71.4%). The sensitivity of malaria RDT (100.0%) was significantly higher in the multigravid women than in the primigravida (78.6%) and secundigravida women (77.8%, P<0.05). The sensitivity of the RDT significantly increased with the intensity of the malarial parasites (P<0.05). CONCLUSION Malaria is endemic in the study populations. Malaria RDT can serve as a first-line of diagnosis for pregnant women in early gestational stages and multigravid women and can aid the differential diagnoses of other diseases due to its high specificity in infants.
Collapse
Affiliation(s)
- Oyetunde T Oyeyemi
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria.
| | - Oluwarotimi J Sode
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - Olalekan D Adebayo
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| | - Grace O Mensah-Agyei
- Department of Biosciences and Biotechnology, Babcock University, Ilishan-Remo, Ogun, Nigeria
| |
Collapse
|
25
|
Atroosh WM, Al-Mekhlafi HM, Al-Jasari A, Sady H, Al-Delaimy AK, Nasr NA, Dawaki S, Abdulsalam AM, Ithoi I, Lau YL, Fong MY, Surin J. Genetic variation of pfhrp2 in Plasmodium falciparum isolates from Yemen and the performance of HRP2-based malaria rapid diagnostic test. Parasit Vectors 2015. [PMID: 26198252 PMCID: PMC4511234 DOI: 10.1186/s13071-015-1008-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The genetic variation in the Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen. Methods This study was conducted in Hodeidah and Al-Mahwit governorates, Yemen. A total of 622 individuals with fever were examined for malaria by CareStart™ malaria HRP2-RDT and Giemsa-stained thin and thick blood films. The Pfhrp2 gene was amplified and sequenced from 180 isolates, and subjected to amino acid repeat types analysis. Results A total of 188 (30.2 %) participants were found positive for P. falciparum by the RDT. Overall, 12 different amino acid repeat types were identified in Yemeni isolates. Six repeat types were detected in all the isolates (100 %) namely types 1, 2, 6, 7, 10 and 12 while types 9 and 11 were not detected in any of the isolates. Moreover, the sensitivity and specificity of the used PfHRP2-based RDTs were high (90.5 % and 96.1 %, respectively). Conclusion The present study provides data on the genetic variation within the pfhrp2 gene, and its potential impact on the PfHRP2-based RDTs commonly used in Yemen. CareStart™ Malaria HRP2-based RDT showed high sensitivity and specificity in endemic areas of Yemen. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1008-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Wahib M Atroosh
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences University of Aden, Aden, Yemen.
| | - Hesham M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Azal National Research Centre, Azal University for Human Development, 447, Sana'a, Yemen. .,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, 1247, Sana'a, Yemen.
| | - Adel Al-Jasari
- National Malaria Control programme, Ministry of Public Health and Population, Sana'a, Yemen.
| | - Hany Sady
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Ahmed K Al-Delaimy
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Nabil A Nasr
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Salwa Dawaki
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Awatif M Abdulsalam
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Init Ithoi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Mun Yik Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Johari Surin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| |
Collapse
|
26
|
Elechi HA, Rabasa AI, Bashir MF, Gofama MM, Ibrahim HA, Askira UM. Uncomplicated malaria in children: The place of rapid diagnostic test. Niger Med J 2015; 56:85-90. [PMID: 25838621 PMCID: PMC4382610 DOI: 10.4103/0300-1652.150686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate. Materials and Methods: In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate. Result: Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001). Conclusion: Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria.
Collapse
Affiliation(s)
| | - Adamu Ibrahim Rabasa
- Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | - Muhammad Faruk Bashir
- Department of Paediatrics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
| | | | | | | |
Collapse
|
27
|
Wangmaung N, Chomean S, Promptmas C, Mas-oodi S, Tanyong D, Ittarat W. Silver quartz crystal microbalance for differential diagnosis of Plasmodium falciparum and Plasmodium vivax in single and mixed infection. Biosens Bioelectron 2014; 62:295-301. [DOI: 10.1016/j.bios.2014.06.052] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/23/2014] [Accepted: 06/24/2014] [Indexed: 12/01/2022]
|
28
|
Oguonu T, Shu E, Ezeonwu BU, Lige B, Derrick A, Umeh RE, Agbo E. The performance evaluation of a urine malaria test (UMT) kit for the diagnosis of malaria in individuals with fever in south-east Nigeria: cross-sectional analytical study. Malar J 2014; 13:403. [PMID: 25316216 PMCID: PMC4203939 DOI: 10.1186/1475-2875-13-403] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate rapid diagnosis is one of the important steps in the effort to reduce morbidity and mortality of malaria. Blood-specific malaria rapid diagnostic tests (RDTs) are currently in use but other body fluid specific diagnostic test kits are being developed. The aim of the present study was to evaluate the performance characteristics of a one-step Urine Malaria Test™ (UMT) dipstick in detecting Plasmodium falciparum HRP2, a poly-histidine antigen in urine of febrile patients for malaria diagnosis. METHODS This was an observational study in which a urine-based malaria test kit was used in malaria diagnosis in a normal field setting. Two hundred and three individuals who presented with fever (≥37.5°C) at seven outpatient clinics in Enugu State during periods of high and low transmission seasons in Southeastern Nigeria were enrolled. Matched samples of urine and blood of consecutively enrolled subjects were tested with UMT and blood smear microscopy. RESULTS With the blood smear microscopy as standard, the disease prevalence was 41.2% and sensitivity for the UMT was 83.75% (CI: 73.81 to 91.95%, Kappa 0.665, p =0.001). The UMT had an LLD of 120 parasites/μl but the sensitivity at parasite density less than ≤200 parasites/μl was 50% and 89.71% at density ≥201 parasites/μl with specificity of 83.48%. The positive and negative predictive values were 77.91% and 88.07%, respectively. CONCLUSION The UMT showed moderate level of sensitivity compared with blood smear microscopy. The test kit requires further improvement on its sensitivity in order to be deployable for field use in malaria endemic regions.
Collapse
Affiliation(s)
- Tagbo Oguonu
- />Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
- />Consortium for Health Research and Advanced Training, College of Medicine University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Elvis Shu
- />Consortium for Health Research and Advanced Training, College of Medicine University of Nigeria Enugu Campus, Enugu, Nigeria
| | | | - Bao Lige
- />Fyodor Biotechnologies Inc, 800-West Baltimore Street, Baltimore, MD 21201 USA
| | - Anne Derrick
- />Fyodor Biotechnologies Inc, 800-West Baltimore Street, Baltimore, MD 21201 USA
| | - Rich E Umeh
- />Consortium for Health Research and Advanced Training, College of Medicine University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Eddy Agbo
- />Fyodor Biotechnologies Inc, 800-West Baltimore Street, Baltimore, MD 21201 USA
| |
Collapse
|
29
|
A novel carbon nanofibers grown on glass microballoons immunosensor: a tool for early diagnosis of malaria. SENSORS 2014; 14:14686-99. [PMID: 25120159 PMCID: PMC4179075 DOI: 10.3390/s140814686] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 07/31/2014] [Accepted: 08/04/2014] [Indexed: 11/17/2022]
Abstract
This paper presents a novel method for direct detection of Plasmodium falciparum histidine rich protein-2 (PfHRP-2) antigen using carbon nanofiber (CNF) forests grown on glass microballoons (NMBs). Secondary antibodies specific to PfHRP-2 densely attached to the CNFs exhibit extraordinary ability for the detection of minute concentrations of Plasmodium species. A sandwich immunoassay protocol was employed, where a glass substrate was used to immobilize primary antibodies at designated capture zones. High signal amplification was obtained in both colorimetric and electrical measurements due to the CNFs through specific binding. As a result, it was possible to detect PfHRP-2 levels as low as 0.025 ng/mL concentration in phosphate buffered saline (PBS) using a visual signal within only 1 min of test duration. Lower limits of 0.01 ng/mL was obtained by measuring the electrical resistivity of the capture zone. This method is also highly selective and specific in identifying PfHRP-2 and other Plasmodium species from the same solution. In addition, the stability of the labeling mechanism eliminates the false signals generated by the use of dyes in current malaria rapid diagnostic test kits (MRDTs). Thus, the rapid, sensitive and high signal amplification capabilities of NMBs is a promising tool for early diagnosis of malaria and other infectious diseases.
Collapse
|
30
|
Mohon AN, Elahi R, Khan WA, Haque R, Sullivan DJ, Alam MS. A new visually improved and sensitive loop mediated isothermal amplification (LAMP) for diagnosis of symptomatic falciparum malaria. Acta Trop 2014; 134:52-7. [PMID: 24613155 PMCID: PMC7117200 DOI: 10.1016/j.actatropica.2014.02.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 02/12/2014] [Accepted: 02/20/2014] [Indexed: 11/03/2022]
Abstract
Introduction of Hydroxy Nepthol Blue (HNB) has lead easy and simple naked eye visualization of the LAMP amplicons. The new primer set was found to be 99.1% sensitive and 99% specific in comparison with microscopy. In comparison with Real Time PCR, sensitivity was 98.1% along with 100% specificity. This new method can detect at least five parasite per μL of blood.
Molecular diagnosis of malaria by nucleotide amplification requires sophisticated and expensive instruments, typically found only in well-established laboratories. Loop-mediated isothermal amplification (LAMP) has provided a new platform for an easily adaptable molecular technique for molecular diagnosis of malaria without the use of expensive instruments. A new primer set has been designed targeting the 18S rRNA gene for the detection of Plasmodium falciparum in whole blood samples. The efficacy of LAMP using the new primer set was assessed in this study in comparison to that of a previously described set of LAMP primers as well as with microscopy and real-time PCR as reference methods for detecting P. falciparum. Pre-addition of hydroxy napthol blue (HNB) in the LAMP reaction caused a distinct color change, thereby improving the visual detection system. The new LAMP assay was found to be 99.1% sensitive compared to microscopy and 98.1% when compared to real-time PCR. Meanwhile, its specificity was 99% and 100% in contrast to microscopy and real-time PCR, respectively. Moreover, the LAMP method was in very good agreement with microscopy and real-time PCR (0.94 and 0.98, respectively). This new LAMP method can detect at least 5 parasites/μL of infected blood within 35 min, while the other LAMP method tested in this study, could detect a minimum of 100 parasites/μL of human blood after 60 min of amplification. Thus, the new method is sensitive and specific, can be carried out in a very short time, and can substitute PCR in healthcare clinics and standard laboratories.
Collapse
|
31
|
Davis KM, Gibson LE, Haselton FR, Wright DW. Simple sample processing enhances malaria rapid diagnostic test performance. Analyst 2014; 139:3026-31. [PMID: 24787948 DOI: 10.1039/c4an00338a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Lateral flow immunochromatographic rapid diagnostic tests (RDTs) are the primary form of medical diagnostic used for malaria in underdeveloped nations. Unfortunately, many of these tests do not detect asymptomatic malaria carriers. In order for eradication of the disease to be achieved, this problem must be solved. In this study, we demonstrate enhancement in the performance of six RDT brands when a simple sample-processing step is added to the front of the diagnostic process. Greater than a 4-fold RDT signal enhancement was observed as a result of the sample processing step. This lowered the limit of detection for RDT brands to submicroscopic parasitemias. For the best performing RDTs the limits of detection were found to be as low as 3 parasites per μL. Finally, through individual donor samples, the correlations between donor source, WHO panel detection scores and RDT signal intensities were explored.
Collapse
Affiliation(s)
- K M Davis
- Department of Chemistry, Vanderbilt University, Station B 351822, Nashville, TN 37235-1822, USA.
| | | | | | | |
Collapse
|
32
|
Samanta S, Samanta S, Haldar R. Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations. Indian J Anaesth 2014; 58:55-8. [PMID: 24700901 PMCID: PMC3968654 DOI: 10.4103/0019-5049.126797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block), intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa) and the role of plasmapheresis in leptospira related jaundice with renal failure.
Collapse
Affiliation(s)
- Sukhen Samanta
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Luckow, Uttar Pradesh, India
| | - Sujay Samanta
- Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rudrashish Haldar
- Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
33
|
Jain P, Chakma B, Patra S, Goswami P. Potential biomarkers and their applications for rapid and reliable detection of malaria. BIOMED RESEARCH INTERNATIONAL 2014; 2014:852645. [PMID: 24804253 PMCID: PMC3996934 DOI: 10.1155/2014/852645] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 02/11/2014] [Indexed: 12/21/2022]
Abstract
Malaria has been responsible for the highest mortality in most malaria endemic countries. Even after decades of malaria control campaigns, it still persists as a disease of high mortality due to improper diagnosis and rapidly evolving drug resistant malarial parasites. For efficient and economical malaria management, WHO recommends that all malaria suspected patients should receive proper diagnosis before administering drugs. It is thus imperative to develop fast, economical, and accurate techniques for diagnosis of malaria. In this regard an in-depth knowledge on malaria biomarkers is important to identify an appropriate biorecognition element and utilize it prudently to develop a reliable detection technique for diagnosis of the disease. Among the various biomarkers, plasmodial lactate dehydrogenase and histidine-rich protein II (HRP II) have received increasing attention for developing rapid and reliable detection techniques for malaria. The widely used rapid detection tests (RDTs) for malaria succumb to many drawbacks which promotes exploration of more efficient economical detection techniques. This paper provides an overview on the current status of malaria biomarkers, along with their potential utilization for developing different malaria diagnostic techniques and advanced biosensors.
Collapse
Affiliation(s)
- Priyamvada Jain
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - Babina Chakma
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - Sanjukta Patra
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - Pranab Goswami
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| |
Collapse
|
34
|
Dhiman S, Goswami D, Kumar D, Rabha B, Sharma DK, Bhola RK, Baruah I, Veer V. Nested PCR detection of Plasmodium malariae from microscopy confirmed P. falciparum samples in endemic area of NE India. Folia Parasitol (Praha) 2014; 60:401-5. [PMID: 24471280 DOI: 10.14411/fp.2013.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study evaluates the performance of OptiMAL-IT test and nested PCR assay in detection of malaria parasites. A total of 76 randomly selected blood samples collected from two malaria endemic areas were tested for malaria parasites using microscopy and OptiMAL-IT test in the field. PCR assays were performed in the laboratory using DNA extracted from blood spots of the same samples collected on the FTA classic cards. Of the total of 61 field confirmed malaria positive samples, only 58 (95%) were detected positive using microscopy in the laboratory. Sensitivity, specificity, positive predictive value, negative predictive value and false discovery rate of OptiMal-IT in comparison to the microscopy were 93%, 83%, 95%, 79% and 5%, respectively. On the other hand, the sensitivity and specificity of PCR assay were 97% and 100%, respectively, whereas positive predictive value, negative predictive value and false discovery rate were 100%, 90% and 0%, respectively. The overall performance of OptiMal-IT and PCR assays for malaria diagnosis was 76% and 97%, respectively. PCR assay enabled the identification of infection with Plasmodium malariae Laveran, 1881 in four samples misidentified by microscopy and Plasmodium-specific antigen (PAN) identified by the OptiMAL-IT test. In addition to the standard methods, such PCR assay could be useful to obtain the real incidence of each malaria parasite species for epidemiological perspectives.
Collapse
Affiliation(s)
- Sunil Dhiman
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India.
| | - Diganta Goswami
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India
| | - Dinesh Kumar
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India
| | - Bipul Rabha
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India
| | | | | | - Indra Baruah
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India
| | - Vijay Veer
- Department of Medical Entomology, Defence Research Laboratory, Tezpur, Assam, India
| |
Collapse
|
35
|
Verma P, Biswas S, Mohan T, Ali S, Rao D. Detection of histidine rich protein & lactate dehydrogenase of Plasmodium falciparum in malaria patients by sandwich ELISA using in-house reagents. Indian J Med Res 2013; 138:977-87. [PMID: 24521645 PMCID: PMC3978991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND & OBJECTIVES Despite major control efforts, malaria remains a major public health problem that still causes high mortality rate worldwide especially in Africa and Asia. Accurate and confirmatory diagnosis before treatment initiation is the only way to control the disease. The present study was undertaken to develop reagents using sandwich ELISA for simultaneous detection of PfHRP2 (Plasmodium falciparum histidine rich protein) and PfLDH (P. falciparum lactate dehydrogenase) antigens in the proven malaria cases. METHODS The antibodies were raised against two epitopes of PfHRP2 protein and three unique and unexplored epitopes of PfLDH protein. These antibodies were able to detect PfHRP2 and PfLDH antigens in culture supernatant and parasitized RBC lysate of P. falciparum, respectively up to 50 parasites/μl. The in-house reagents were tested in 200 P. falciparum positive patients residing in Baghpat district of Uttar Pradesh in northern India. RESULTS Microsphere (PLGA) with CpG ODN were used to generate high titre and high affinity antibodies against selected peptides of PfHRP-2 and pLDH antigen in mice and rabbit. The peptide specific peak titre varied from 12,800 - 102,400 with an affinity ranging 0.73 - 3.0 mM. The indigenously developed reagents are able to detect PfHRP2 and PfLDH antigens as low as 75 parasites/μl of blood with a very high sensitivity (96-100%) and specificity (100%). INTERPRETATION & CONCLUSIONS The study highlight the identification of unique epitopes of PfHRP2 and PfLDH, and the generated antibodies against these antigens were used for quantitative estimation of these two antigens using sandwich ELISA. No corresreactivity with P. vivax infected patients was observed with the sera.
Collapse
Affiliation(s)
- Priyanka Verma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sukla Biswas
- National Institute of Malaria Research (ICMR), New Delhi, India
| | - Teena Mohan
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Shakir Ali
- Department of Biochemistry, Jamia Hamdard University, New Delhi, India
| | - D.N. Rao
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India,Reprint requests: Dr D.N. Rao, Department of Biochemistry, All India Institute of Medical Sciences Ansari Nagar, New Delhi 110 029, India e-mail:
| |
Collapse
|
36
|
Elahi R, Mohon AN, Khan WA, Haque R, Alam MS. Performance of a HRP-2/pLDH based rapid diagnostic test at the Bangladesh-India-Myanmar border areas for diagnosis of clinical malaria. Malar J 2013; 12:378. [PMID: 24172045 PMCID: PMC4228469 DOI: 10.1186/1475-2875-12-378] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 10/28/2013] [Indexed: 11/10/2022] Open
Abstract
Background The rapid diagnostic test (RDT) has been adopted in contemporary malaria control and management programmes around the world as it represents a fast and apt alternative for malaria diagnosis in a resource-limited setting. This study assessed the performance of a HRP-2/pLDH based RDT (Parascreen® Pan/Pf) in a laboratory setting utilizing clinical samples obtained from the field. Methods Whole blood samples were obtained from febrile patients referred for malaria diagnosis by clinicians from two different Upazila Health Complexes (UHCs) located near the Bangladesh-India and Bangladesh-Myanmar border where malaria is endemic. RDT was performed on archived samples and sensitivity and specificity evaluated with expert microscopy (EM) and quantitative PCR (qPCR). Results A total of 327 clinical samples were made available for the study, of which 153 were Plasmodium falciparum-positive and 54 were Plasmodium vivax-positive. In comparison with EM, for P. falciparum malaria, the RDT had sensitivity: 96.0% (95% CI, 91.2-98.3) and specificity: 98.2% (95% CI, 94.6-99.5) and for P. vivax, sensitivity: 90.7% (95% CI, 78.9-96.5) and specificity: 98.9% (95% CI, 96.5-99.7). Comparison with qPCR showed, for P. falciparum malaria, sensitivity: 95.4% (95% CI, 90.5-98.0) and specificity: 98.8% (95% CI, 95.4-99.7) and for P. vivax malaria, sensitivity: 89.0% (95% CI,77.0-95.4) and specificity: 98.8% (95% CI, 96.5-99.7). Sensitivity varied according to different parasitaemia for falciparum and vivax malaria diagnosis. Conclusion Parascreen® Pan/Pf Rapid test for malaria showed acceptable sensitivity and specificity in border belt endemic areas of Bangladesh when compared with EM and qPCR.
Collapse
Affiliation(s)
| | | | | | | | - Mohammad Shafiul Alam
- International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
| |
Collapse
|
37
|
Lee LG, Nordman ES, Johnson MD, Oldham MF. A low-cost, high-performance system for fluorescence lateral flow assays. BIOSENSORS-BASEL 2013; 3:360-73. [PMID: 25586412 PMCID: PMC4263565 DOI: 10.3390/bios3040360] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/09/2013] [Accepted: 10/10/2013] [Indexed: 11/16/2022]
Abstract
We demonstrate a fluorescence lateral flow system that has excellent sensitivity and wide dynamic range. The illumination system utilizes an LED, plastic lenses and plastic and colored glass filters for the excitation and emission light. Images are collected on an iPhone 4. Several fluorescent dyes with long Stokes shifts were evaluated for their signal and nonspecific binding in lateral flow. A wide range of values for the ratio of signal to nonspecific binding was found, from 50 for R-phycoerythrin (R-PE) to 0.15 for Brilliant Violet 605. The long Stokes shift of R-PE allowed the use of inexpensive plastic filters rather than costly interference filters to block the LED light. Fluorescence detection with R-PE and absorbance detection with colloidal gold were directly compared in lateral flow using biotinylated bovine serum albumen (BSA) as the analyte. Fluorescence provided linear data over a range of 0.4–4,000 ng/mL with a 1,000-fold signal change while colloidal gold provided non-linear data over a range of 16–4,000 ng/mL with a 10-fold signal change. A comparison using human chorionic gonadotropin (hCG) as the analyte showed a similar advantage in the fluorescent system. We believe our inexpensive yet high-performance platform will be useful for providing quantitative and sensitive detection in a point-of-care setting.
Collapse
Affiliation(s)
- Linda G Lee
- Song Diagnostic Research LLC, 1 Megans Lane, Woodside, CA 94062, USA.
| | - Eric S Nordman
- Song Diagnostic Research LLC, 1 Megans Lane, Woodside, CA 94062, USA.
| | - Martin D Johnson
- Song Diagnostic Research LLC, 1 Megans Lane, Woodside, CA 94062, USA.
| | - Mark F Oldham
- Song Diagnostic Research LLC, 1 Megans Lane, Woodside, CA 94062, USA.
| |
Collapse
|
38
|
Aydin-Schmidt B, Mubi M, Morris U, Petzold M, Ngasala BE, Premji Z, Björkman A, Mårtensson A. Usefulness of Plasmodium falciparum-specific rapid diagnostic tests for assessment of parasite clearance and detection of recurrent infections after artemisinin-based combination therapy. Malar J 2013; 12:349. [PMID: 24079306 PMCID: PMC3849780 DOI: 10.1186/1475-2875-12-349] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/20/2013] [Indexed: 11/24/2022] Open
Abstract
Background Rapid diagnostic test (RDT) is an important tool for parasite-based malaria diagnosis. High specificity of RDTs to distinguish an active Plasmodium falciparum infection from residual antigens from a previous infection is crucial in endemic areas where residents are repeatedly exposed to malaria. The efficiency of two RDTs based on histidine-rich protein 2 (HRP2) and lactate dehydrogenase (LDH) antigens were studied and compared with two microscopy techniques (Giemsa and acridine orange-stained blood smears) and real-time polymerase chain reaction (PCR) for assessment of initial clearance and detection of recurrent P. falciparum infections after artemisinin-based combination therapy (ACT) in a moderately high endemic area of rural Tanzania. Methods In this exploratory study 53 children < five years with uncomplicated P. falciparum malaria infection were followed up on nine occasions, i.e., day 1, 2, 3, 7, 14, 21, 28, 35 and 42, after initiation of artemether-lumefantrine treatment. At each visit capillary blood samples was collected for the HRP2 and LDH-based RDTs, Giemsa and acridine orange-stained blood smears for microscopy and real-time PCR. Assessment of clearance times and detection of recurrent P. falciparum infections were done for all diagnostic methods. Results The median clearance times were 28 (range seven to >42) and seven (two to 14) days for HRP2 and LDH-based RDTs, two (one to seven) and two (one to 14) days for Giemsa and acridine orange-stained blood smear and two (one to 28) days for real-time PCR. RDT specificity against Giemsa-stained blood smear microscopy was 21% for HRP2 on day 14, reaching 87% on day 42, and ≥96% from day 14 to 42 for LDH. There was no significant correlation between parasite density at enrolment and duration of HRP2 positivity (r = 0.13, p = 0.34). Recurrent malaria infections occurred in ten (19%) children. The HRP2 and LDH-based RDTs did not detect eight and two of the recurrent infections, respectively. Conclusion The LDH-based RDT was superior to HRP2-based for monitoring of treatment outcome and detection of recurrent infections after ACT in this moderately high transmission setting. The results may have implications for the choice of RDT devices in similar transmission settings for improved malaria case management. Trial registration Clinicaltrials.gov, NCT01843764
Collapse
Affiliation(s)
- Berit Aydin-Schmidt
- Malaria Research, Department of Medicine-Solna, Karolinska University Hospital/Karolinska Institutet, Stockholm, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Malaria pigment crystals as magnetic micro-rotors: key for high-sensitivity diagnosis. Sci Rep 2013; 3:1431. [PMID: 23478535 PMCID: PMC3594758 DOI: 10.1038/srep01431] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/27/2013] [Indexed: 11/24/2022] Open
Abstract
The need to develop new methods for the high-sensitivity diagnosis of malaria has initiated a global activity in medical and interdisciplinary sciences. Most of the diverse variety of emerging techniques are based on research-grade instruments, sophisticated reagent-based assays or rely on expertise. Here, we suggest an alternative optical methodology with an easy-to-use and cost-effective instrumentation based on unique properties of malaria pigment reported previously and determined quantitatively in the present study. Malaria pigment, also called hemozoin, is an insoluble microcrystalline form of heme. These crystallites show remarkable magnetic and optical anisotropy distinctly from any other components of blood. As a consequence, they can simultaneously act as magnetically driven micro-rotors and spinning polarizers in suspensions. These properties can gain importance not only in malaria diagnosis and therapies, where hemozoin is considered as drug target or immune modulator, but also in the magnetic manipulation of cells and tissues on the microscopic scale.
Collapse
|
40
|
Jang JW, Cho CH, Han ET, An SSA, Lim CS. pLDH level of clinically isolated Plasmodium vivax and detection limit of pLDH based malaria rapid diagnostic test. Malar J 2013; 12:181. [PMID: 23731660 PMCID: PMC3686627 DOI: 10.1186/1475-2875-12-181] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 05/30/2013] [Indexed: 12/02/2022] Open
Abstract
Background The malaria rapid diagnostic tests (RDTs) are now widely used in the world. Compared to Plasmodium falciparum, a poor sensitivity of RDTs was reported against Plasmodium vivax based on the adopted antibody against pan-Plasmodium antigen lactate dehydrogenase (pLDH) or aldolase. Levels of pLDH were measured from patient with P. vivax, and the correlations between the levels of pLDH and the sensitivities of RDTs were analysed among Republic of Korea (ROK) isolates. Methods Three RDTs, OptiMAL test, SD BIOLINE Malaria Ag P.f/Pan test, Humasis Malaria Pf/Pan antigen test, and the Genedia pLDH antigen ELISA were performed with blood samples from 152 febrile patients and 100 healthy controls. Results Three malaria RDTs revealed sensitivities between 85.5 (131/152) and 86.8% (132/152) with highest sensitivity for the detection of P.vivax by pLDH antigen ELISA test (145/152, 95.4%) in comparison to traditional microscopy using Giemsa–stained slides. None of the healthy control tested positive by three RDTs or ELISA, indicating 100% specificity in their respective test. Levels of pLDH among Korean P. vivax isolates ranged between 0 ng/mL and 22,387.2 ng/mL (mean ± standard deviation 3,917.5 ± 6,120.9 ng/mL). The lower detection limits of three RDTs were between 25 and 50 ng/mL with artificially diluted samples. The moderate degree of correlation was observed between parasitaemia and concentrations of pLDH (r = 0.4, p < 0.05). Conclusion The pLDH levels of P. vivax are the main explanation for the variations in the performance of pLDH-based RDTs. Therefore, comparing sensitivities of RDT may need to include targeted biomarker value of patients.
Collapse
|
41
|
Abstract
Plasmodium knowlesi is a malaria parasite that is found in nature in long-tailed and pig-tailed macaques. Naturally acquired human infections were thought to be extremely rare until a large focus of human infections was reported in 2004 in Sarawak, Malaysian Borneo. Human infections have since been described throughout Southeast Asia, and P. knowlesi is now recognized as the fifth species of Plasmodium causing malaria in humans. The molecular, entomological, and epidemiological data indicate that human infections with P. knowlesi are not newly emergent and that knowlesi malaria is primarily a zoonosis. Human infections were undiagnosed until molecular detection methods that could distinguish P. knowlesi from the morphologically similar human malaria parasite P. malariae became available. P. knowlesi infections cause a spectrum of disease and are potentially fatal, but if detected early enough, infections in humans are readily treatable. In this review on knowlesi malaria, we describe the early studies on P. knowlesi and focus on the epidemiology, diagnosis, clinical aspects, and treatment of knowlesi malaria. We also discuss the gaps in our knowledge and the challenges that lie ahead in studying the epidemiology and pathogenesis of knowlesi malaria and in the prevention and control of this zoonotic infection.
Collapse
Affiliation(s)
- Balbir Singh
- Malaria Research Centre, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia.
| | | |
Collapse
|
42
|
Osei-Kwakye K, Asante KP, Mahama E, Apanga S, Owusu R, Kwara E, Adjei G, Abokyi L, Yeetey E, Dosoo DK, Punguyire D, Owusu-Agyei S. The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. PLoS One 2013; 8:e58107. [PMID: 23505457 PMCID: PMC3591456 DOI: 10.1371/journal.pone.0058107] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 01/30/2013] [Indexed: 11/19/2022] Open
Abstract
Background This study was conducted at the Kintampo Municipal Hospital in Ghana to determine whether there was any benefit (or otherwise) in basing the management of cases of suspected malaria solely on laboratory confirmation (microscopy or by RDT) as compared with presumptive diagnosis. Method Children under five years who reported at the Out-Patient Department of the Hospital with axillary temperature ≥37.5°C or with a 48 hr history of fever were enrolled and had malaria microscopy and RDT performed. The attending clinician was blinded from laboratory results unless a request for these tests had been made earlier. Diagnosis of malaria was based on three main methods: presumptive or microscopy and/or RDT. Cost implication for adopting laboratory diagnosis or not was determined to inform malaria control programmes. Results In total, 936 children were enrolled in the study. Proportions of malaria diagnosed presumptively, by RDT and microscopy were 73.6% (689/936), 66.0% (618/936) and 43.2% (404/936) respectively. Over 50% (170/318) of the children who were RDT negative and 60% (321/532) who were microscopy negative were treated for malaria when presumptive diagnoses were used. Comparing the methods of diagnoses, the cost of malaria treatment could have been reduced by 24% and 46% in the RDT and microscopy groups respectively; the reduction was greater in the dry season (43% vs. 50%) compared with the wet season (20% vs. 45%) for the RDT and microscopy confirmed cases respectively. Discussion/Conclusion Over-diagnosis of malaria was prevalent in Kintampo during the period of the study. Though the use of RDT for diagnosis of malaria might have improved the quality of care for children, it appeared not to have a cost saving effect on the management of children with suspected malaria. Further research may be needed to confirm this.
Collapse
Affiliation(s)
- Kingsley Osei-Kwakye
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Emmanuel Mahama
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Stephen Apanga
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Ruth Owusu
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Evans Kwara
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - George Adjei
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Livesy Abokyi
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Enuameh Yeetey
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - David Kwame Dosoo
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Damien Punguyire
- Kintampo Municipal Hospital, Ghana Health Service, Ministry of Health, Kintampo, Ghana
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Ministry of Health, Kintampo, Ghana
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| |
Collapse
|
43
|
Saha RK, Karmakar S, Roy M. Computational investigation on the photoacoustics of malaria infected red blood cells. PLoS One 2012; 7:e51774. [PMID: 23272166 PMCID: PMC3522742 DOI: 10.1371/journal.pone.0051774] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/12/2012] [Indexed: 11/19/2022] Open
Abstract
A computer simulation study on the possibility of using photoacoustic (PA) technique to differentiate intraerythrocytic stages of malarial parasite is reported. This parasite during its development substantially converts hemoglobin into hemozoin. This conversion is expected to alter the cellular absorption leading to changes in the PA emission of a red blood cell (RBC) at certain incident optical wavelengths. The PA signals from blood samples corresponding to ring, trophozoite and schizont stages were computed and compared with that of normal blood. A Monte Carlo algorithm was implemented generating random locations of RBCs in 3D to simulate blood samples. The average PA amplitude for wide bandwidth signals decreases for 434 nm incident radiation, but increases for 700 nm as the parasite matures. The spectral power at 7.5 MHz for the blood sample at the schizont stage compared to the normal blood is nearly reduced by 6 dB and enhanced by 22 dB at those incident wavelengths, respectively. Bandlimited signals for transducers of 15 and 50 MHz center frequencies were studied and found to exhibit similar characteristics. The presence of hemozoin inside the cells was examined and an excellent estimation was made. The simulation results suggest that intraerythrocytic stages of malarial parasite may be assessed using the PA technique.
Collapse
Affiliation(s)
- Ratan K Saha
- Ratan K Saha Applied Material Science Division, Saha Institute of Nuclear Physics, Kolkata, West Bengal, India.
| | | | | |
Collapse
|
44
|
Mohon AN, Elahi R, Podder MP, Mohiuddin K, Hossain MS, Khan WA, Haque R, Alam MS. Evaluation of the OnSite (Pf/Pan) rapid diagnostic test for diagnosis of clinical malaria. Malar J 2012; 11:415. [PMID: 23234579 PMCID: PMC3544592 DOI: 10.1186/1475-2875-11-415] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/10/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Accurate diagnosis of malaria is an essential prerequisite for proper treatment and drug resistance monitoring. Microscopy is considered the gold standard for malaria diagnosis but has limitations. ELISA, PCR, and Real Time PCR are also used to diagnose malaria in reference laboratories, although their application at the field level is currently not feasible. Rapid diagnostic tests (RDTs) however, have been brought into field operation and widely adopted in recent days. This study evaluates OnSite (Pf/Pan) antigen test, a new RDT introduced by CTK Biotech Inc, USA for malaria diagnosis in a reference setting. METHODS Blood samples were collected from febrile patients referred for malaria diagnosis by clinicians. Subjects were included in this study from two different Upazila Health Complexes (UHCs) situated in two malaria endemic districts of Bangladesh. Microscopy and nested PCR were considered the gold standard in this study. OnSite (Pf/Pan) RDT was performed on preserved whole blood samples. RESULTS In total, 372 febrile subjects were included in this study. Of these subjects, 229 (61.6%) tested positive for Plasmodium infection detected by microscopy and nested PCR. OnSite (Pf/Pan) RDT was 94.2% sensitive (95% CI, 89.3-97.3) and 99.5% specific (95% CI, 97.4-00.0) for Plasmodium falciparum diagnosis and 97.3% sensitive (95% CI, 90.5-99.7) and 98.7% specific (95% CI, 96.6-99.6) for Plasmodium vivax diagnosis. Sensitivity varied with differential parasite count for both P. falciparum and P. vivax. The highest sensitivity was observed in febrile patients with parasitaemia that ranged from 501-1,000 parasites/μL regardless of the Plasmodium species. CONCLUSION The new OnSite (Pf/Pan) RDT is both sensitive and specific for symptomatic malaria diagnosis in standard laboratory conditions.
Collapse
Affiliation(s)
- Abu Naser Mohon
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rubayet Elahi
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Milka Patracia Podder
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
- Department of Biology, Memorial University of Newfoundland, St. John’s, Canada
| | - Khaja Mohiuddin
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Wasif A Khan
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Shafiul Alam
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
45
|
Chaki PP, Mlacha Y, Msellemu D, Muhili A, Malishee AD, Mtema ZJ, Kiware SS, Zhou Y, Lobo NF, Russell TL, Dongus S, Govella NJ, Killeen GF. An affordable, quality-assured community-based system for high-resolution entomological surveillance of vector mosquitoes that reflects human malaria infection risk patterns. Malar J 2012; 11:172. [PMID: 22624853 PMCID: PMC3475008 DOI: 10.1186/1475-2875-11-172] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 05/10/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND More sensitive and scalable entomological surveillance tools are required to monitor low levels of transmission that are increasingly common across the tropics, particularly where vector control has been successful. A large-scale larviciding programme in urban Dar es Salaam, Tanzania is supported by a community-based (CB) system for trapping adult mosquito densities to monitor programme performance. METHODOLOGY An intensive and extensive CB system for routine, longitudinal, programmatic surveillance of malaria vectors and other mosquitoes using the Ifakara Tent Trap (ITT-C) was developed in Urban Dar es Salaam, Tanzania, and validated by comparison with quality assurance (QA) surveys using either ITT-C or human landing catches (HLC), as well as a cross-sectional survey of malaria parasite prevalence in the same housing compounds. RESULTS Community-based ITT-C had much lower sensitivity per person-night of sampling than HLC (Relative Rate (RR) [95% Confidence Interval (CI)] = 0.079 [0.051, 0.121], P < 0.001 for Anopheles gambiae s.l. and 0.153 [0.137, 0.171], P < 0.001 for Culicines) but only moderately differed from QA surveys with the same trap (0.536 [0.406,0.617], P = 0.001 and 0.747 [0.677,0.824], P < 0.001, for An. gambiae or Culex respectively). Despite the poor sensitivity of the ITT per night of sampling, when CB-ITT was compared with QA-HLC, it proved at least comparably sensitive in absolute terms (171 versus 169 primary vectors caught) and cost-effective (153US$ versus 187US$ per An. gambiae caught) because it allowed more spatially extensive and temporally intensive sampling (4284 versus 335 trap nights distributed over 615 versus 240 locations with a mean number of samples per year of 143 versus 141). Despite the very low vectors densities (Annual estimate of about 170 An gambiae s.l bites per person per year), CB-ITT was the only entomological predictor of parasite infection risk (Odds Ratio [95% CI] = 4.43[3.027,7. 454] per An. gambiae or Anopheles funestus caught per night, P =0.0373). DISCUSSION AND CONCLUSION CB trapping approaches could be improved with more sensitive traps, but already offer a practical, safe and affordable system for routine programmatic mosquito surveillance and clusters could be distributed across entire countries by adapting the sample submission and quality assurance procedures accordingly.
Collapse
Affiliation(s)
- Prosper P Chaki
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Liverpool School of Tropical Medicine, Vector Group, Pembroke Place, Liverpool L3 5QA, UK
| | - Yeromin Mlacha
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Liverpool School of Tropical Medicine, Vector Group, Pembroke Place, Liverpool L3 5QA, UK
| | - Daniel Msellemu
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, UK
| | - Athuman Muhili
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
| | - Alpha D Malishee
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
| | - Zacharia J Mtema
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, College of Medicine, Veterinary Medicine and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Samson S Kiware
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Department of Mathematics, Statistics, and Computer Science, Marquette University, Milwaukee, WI 53201-1881, USA
| | - Ying Zhou
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Tanya L Russell
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- James Cook University, School of Public Health, Tropical Medicine and Rehabilitation Sciences, Cairns, 4870, Australia
| | - Stefan Dongus
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Liverpool School of Tropical Medicine, Vector Group, Pembroke Place, Liverpool L3 5QA, UK
| | - Nicodem J Govella
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Liverpool School of Tropical Medicine, Vector Group, Pembroke Place, Liverpool L3 5QA, UK
| | - Gerry F Killeen
- Ifakara Health Institute, Coordination Office, Kiko Avenue, Mikocheni, PO Box 78373, Dar es Salaam, United Republic of Tanzania
- Liverpool School of Tropical Medicine, Vector Group, Pembroke Place, Liverpool L3 5QA, UK
| |
Collapse
|
46
|
Tekeste Z, Workineh M, Petros B. Comparison of Paracheck Pf® test with conventional light microscopy for the diagnosis of malaria in Ethiopia. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2012. [DOI: 10.1016/s2222-1808(12)60001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
47
|
White MT, Conteh L, Cibulskis R, Ghani AC. Costs and cost-effectiveness of malaria control interventions--a systematic review. Malar J 2011; 10:337. [PMID: 22050911 PMCID: PMC3229472 DOI: 10.1186/1475-2875-10-337] [Citation(s) in RCA: 179] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 11/03/2011] [Indexed: 11/10/2022] Open
Abstract
Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54) for ITNs, $6.70 (range $2.22-$12.85) for IRS, $0.60 (range $0.48-$1.08) for IPT in infants, $4.03 (range $1.25-$11.80) for IPT in children, and $2.06 (range $0.47-$3.36) for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34). The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65) and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87). Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110) for ITNs, $143 (range $135-$150) for IRS, and $24 (range $1.08-$44.24) for IPT. Conclusions A transparent evidence base on the costs and cost-effectiveness of malaria control interventions is provided to inform rational resource allocation by donors and domestic health budgets and the selection of optimal packages of interventions by malaria control programmes.
Collapse
Affiliation(s)
- Michael T White
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
| | | | | | | |
Collapse
|
48
|
Study and evaluation of Wondfo rapid diagnostic kit based on nano-gold immunochromatography assay for diagnosis of Plasmodium falciparum. Parasitol Res 2011; 110:1421-5. [PMID: 21922236 DOI: 10.1007/s00436-011-2643-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 09/05/2011] [Indexed: 10/17/2022]
Abstract
Malaria has been recognized as a human disease for thousands of years and remains one of the most common diseases affecting humans worldwide. Therefore, a method for rapidly detecting Plasmodium falciparum is necessary and useful. We have developed Wondfo rapid diagnostic kit based on nano-gold immunochromatography assay for the detection of P. falciparum in patient specimen. In the present study, we demonstrated the sensitivity and specificity of the rapid diagnostic kit in which nano-gold labeling techniques and the monoclonal antibodies against histidine-rich protein-2 of P. falciparum were used to establish two-antibody sandwich immunochromatographic assay for detecting P. falciparum. By using microscopic examination of blood smears as control, the sensitivity, specificity, and feasibility of Wondfo rapid diagnostic kit was determined in the prompt and accurate diagnosis of malaria. In this study, 1,558 blood samples were collected from outpatient clinics in China and detected by both Wondfo kit and microscopic examination. The Wondfo kit did not show cross-reaction with microfilaria, Toxoplasma gondii, and other parasites in the blood. The patient samples positive for rheumatoid factor, HIV, tuberculosis, and syphilis did not show false positivity when testing with Wondfo kit. The detection sensitivity and specificity of Wondfo rapid diagnostic kit were 95.49% and 99.53%, respectively. These results indicate that our rapid diagnostic assay may be useful for detecting P. falciparum in patient specimen.
Collapse
|
49
|
Nilles EJ, Arguin PM. Imported malaria: an update. Am J Emerg Med 2011; 30:972-80. [PMID: 21908138 DOI: 10.1016/j.ajem.2011.06.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 06/10/2011] [Accepted: 06/15/2011] [Indexed: 11/29/2022] Open
Abstract
Evidence suggests that imported malaria is a diagnostic challenge with initial misdiagnosis rates of 40% or greater. Given that prompt diagnosis and appropriate treatment are the only intervention proven to prevent progression to severe malaria and death, these figures are concerning. The purpose of this clinical review is to provide the most up-to-date and practical information on the diagnosis and treatment of imported malaria for the emergency health care provider. We highlight common pitfalls, errors, and mistakes in arriving at the correct diagnosis. We also emphasize the 3 key aspects to avoid progression to severe disease: rapid diagnosis, prompt initiation of treatment, and appropriate choice of antimalarial treatment.
Collapse
Affiliation(s)
- Eric J Nilles
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
| | | |
Collapse
|
50
|
Piper RC, Buchanan I, Choi YH, Makler MT. Opportunities for improving pLDH-based malaria diagnostic tests. Malar J 2011; 10:213. [PMID: 21806821 PMCID: PMC3163226 DOI: 10.1186/1475-2875-10-213] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 08/01/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monoclonal antibodies to Plasmodium lactate dehydrogenase (pLDH) have been previously used to format immunochromatographic tests for the diagnosis of malaria. Using pLDH as an antigen has several advantages as a sensitive measure of the presence of parasites within patient blood samples. However, variable results in terms of specificity and sensitivity among different commercially available diagnostic kits have been reported and it has not been clear from these studies whether the performance of an individual test is due simply to how it is engineered or whether it is due to the biochemical nature of the pLDH-antibody reaction itself. METHODS A series of systematic studies to determine how various pLDH monoclonal antibodies work in combination was undertaken. Different combinations of anti-pLDH monoclonal antibodies were used in a rapid-test immunochromatographic assay format to determine parameters of sensitivity and specificity with regard to individual Plasmodium species. RESULTS Dramatic differences were found in both species specificity and overall sensitivity depending on which antibody is used on the immunochromatographic strip and which is used on the colorimetric colloidal-gold used for visual detection. DISCUSSION The results demonstrate the feasibility of different test formats for the detection and speciation of malarial infections. In addition, the data will enable the development of a universal rapid test algorithm that may potentially provide a cost-effective strategy to diagnose and manage patients in a wide range of clinical settings. CONCLUSION These data emphasize that using different anti-pLDH antibody combinations offers a tractable way to optimize immunochromatographic pLDH tests.
Collapse
Affiliation(s)
- Robert C Piper
- Flow Incorporated, 6127 SW Corbett, Portland, OR 97239-3601, USA.
| | | | | | | |
Collapse
|