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López-Guzmán C, García AM, Ramirez JD, Aliaga TT, Fernández-Moya A, Kemmerling U, Vásquez AM. Plasmodium falciparum alters the trophoblastic barrier and stroma villi organization of human placental villi explants. Malar J 2024; 23:130. [PMID: 38693572 PMCID: PMC11064279 DOI: 10.1186/s12936-024-04960-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND The sequestration of Plasmodium falciparum infected erythrocytes in the placenta, and the resulting inflammatory response affects maternal and child health. Despite existing information, little is known about the direct impact of P. falciparum on the placental barrier formed by trophoblast and villous stroma. This study aimed to assess placental tissue damage caused by P. falciparum in human placental explants (HPEs). METHODS HPEs from chorionic villi obtained of human term placentas (n = 9) from normal pregnancies were exposed to P. falciparum-infected erythrocytes (IE) for 24 h. HPEs were embedded in paraffin blocks and used to study tissue damage through histopathological and histochemical analysis and apoptosis using TUNEL staining. Culture supernatants were collected to measure cytokine and angiogenic factors and to determine LDH activity as a marker of cytotoxicity. A subset of archived human term placenta paraffin-embedded blocks from pregnant women with malaria were used to confirm ex vivo findings. RESULTS Plasmodium falciparum-IE significantly damages the trophoblast layer and the villous stroma of the chorionic villi. The increased LDH activity and pathological findings such as syncytial knots, fibrin deposits, infarction, trophoblast detachment, and collagen disorganization supported these findings. The specific damage to the trophoblast and the thickening of the subjacent basal lamina were more pronounced in the ex vivo infection. In contrast, apoptosis was higher in the in vivo infection. This disparity could be attributed to the duration of exposure to the infection, which significantly varied between individuals naturally exposed over time and the 24-h exposure in the ex vivo HPE model. CONCLUSION Exposure to P. falciparum-IE induces a detachment of the syncytiotrophoblast, disorganization of the stroma villi, and an increase in apoptosis, alterations that may be associated with adverse results such as intrauterine growth restriction and low birth weight.
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Affiliation(s)
- Carolina López-Guzmán
- Grupo Malaria, Facultad de Medicina, Universidad de Antioquia, Calle 62 #52-59 Torre 1, Laboratorio 610, Medellín, Colombia
| | - Ana María García
- Grupo Malaria, Facultad de Medicina, Universidad de Antioquia, Calle 62 #52-59 Torre 1, Laboratorio 610, Medellín, Colombia
| | - Juan Diego Ramirez
- Grupo Malaria, Facultad de Medicina, Universidad de Antioquia, Calle 62 #52-59 Torre 1, Laboratorio 610, Medellín, Colombia
| | - Trinidad Torres Aliaga
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Alejandro Fernández-Moya
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Ulrike Kemmerling
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia 1027, Santiago, Chile
| | - Ana María Vásquez
- Grupo Malaria, Facultad de Medicina, Universidad de Antioquia, Calle 62 #52-59 Torre 1, Laboratorio 610, Medellín, Colombia.
- Escuela de Microbiología, Universidad de Antioquia, Calle 67 # 53-108, Bloque 5, Oficina 5-135, Medellín, Colombia.
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Hellingman A, Sifoniou K, Buser T, Thommen BT, Walz A, Passecker A, Collins J, Hupfeld M, Wittlin S, Witmer K, Brancucci NMB. Next Generation Chemiluminescent Probes for Antimalarial Drug Discovery. ACS Infect Dis 2024; 10:1286-1297. [PMID: 38556981 PMCID: PMC11019541 DOI: 10.1021/acsinfecdis.3c00707] [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: 12/18/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Malaria is caused by parasites of the Plasmodium genus and remains one of the most pressing human health problems. The spread of parasites resistant to or partially resistant to single or multiple drugs, including frontline antimalarial artemisinin and its derivatives, poses a serious threat to current and future malaria control efforts. In vitro drug assays are important for identifying new antimalarial compounds and monitoring drug resistance. Due to its robustness and ease of use, the [3H]-hypoxanthine incorporation assay is still considered a gold standard and is widely applied, despite limited sensitivity and the dependence on radioactive material. Here, we present a first-of-its-kind chemiluminescence-based antimalarial drug screening assay. The effect of compounds on P. falciparum is monitored by using a dioxetane-based substrate (AquaSpark β-D-galactoside) that emits high-intensity luminescence upon removal of a protective group (β-D-galactoside) by a transgenic β-galactosidase reporter enzyme. This biosensor enables highly sensitive, robust, and cost-effective detection of asexual, intraerythrocytic P. falciparum parasites without the need for parasite enrichment, washing, or purification steps. We are convinced that the ultralow detection limit of less than 100 parasites of the presented biosensor system will become instrumental in malaria research, including but not limited to drug screening.
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Affiliation(s)
- Angela Hellingman
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Kleopatra Sifoniou
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Tamara Buser
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Basil T. Thommen
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Annabelle Walz
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Armin Passecker
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | | | | | - Sergio Wittlin
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
| | - Kathrin Witmer
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
- NEMIS
Technologies AG, 8804 Au, ZH, Switzerland
| | - Nicolas M. B. Brancucci
- Department
of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- University
of Basel, 4001 Basel, Switzerland
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3
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Omorou R, Delabie B, Lavoignat A, Chaker V, Bonnot G, Traore K, Bienvenu AL, Picot S. Nanoparticle tracking analysis of natural hemozoin from Plasmodium parasites. Acta Trop 2024; 250:107105. [PMID: 38135133 DOI: 10.1016/j.actatropica.2023.107105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Hemozoin is a byproduct of hemoglobin digestion crucial for parasite survival. It forms crystals that can be of interest as drug targets or biomarkers of malaria infection. However, hemozoin has long been considered as an amorphous crystal of simple morphology. Studying the consequences of biomineralization of this crystal during the parasite growth may provide more comprehensive evidence of its role during malaria. OBJECTIVES This study aimed to investigate the interest of nanoparticles tracker analysis for measuring the concentration and size of hemozoin particles produced from different parasite sources and conditions. METHODS Hemozoin was extracted from several clones of Plasmodium falciparum both asexual and sexual parasites. Hemozoin was also extracted from blood samples of malaria patients and from saliva of asymptomatic malaria carriers. Nanoparticles tracking analysis (NTA) was performed to assess the size and concentration of hemozoin. RESULTS NTA data showed variation in hemozoin concentration, size, and crystal clusters between parasite clones, species, and stages. Among parasite clones, hemozoin concentration ranged from 131 to 2663 particles/infected red blood cell (iRBC) and size ranged from 149.6 ± 6.3 nm to 234.8 ± 40.1 nm. The mean size was lower for Plasmodium vivax (176 ± 79.2 nm) than for Plasmodium falciparum (254.8 ± 74.0 nm). Sexual NF54 parasites showed a 7.5-fold higher concentration of hemozoin particles (28.7 particles/iRBC) compared to asexual parasites (3.8 particles/iRBC). In addition, the mean hemozoin size also increased by approximately 60 % for sexual parasites. Compared to in vitro cultures of parasites, blood samples showed low hemozoin concentrations. CONCLUSIONS This study highlights the potential of NTA as a useful method for analyzing hemozoin, demonstrating its ability to provide detailed information on hemozoin characterization. However, further research is needed to adapt the NTA for hemozoin analysis.
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Affiliation(s)
- Roukayatou Omorou
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France.
| | - Blanche Delabie
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France
| | - Adeline Lavoignat
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France
| | - Victorien Chaker
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France
| | - Guillaume Bonnot
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France
| | - Karim Traore
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Anne-Lise Bienvenu
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France; Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon 69004, France
| | - Stephane Picot
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE, University Lyon1, University Lyon, Villeurbanne 69100, France; Institute of Parasitology and Medical Mycology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon 69004, France
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Tan AF, Thota P, Sakam SSB, Lew YL, Rajahram GS, William T, Barber BE, Kho S, Anstey NM, Bell D, Grigg MJ. Evaluation of a point-of-care haemozoin assay (Gazelle device) for rapid detection of Plasmodium knowlesi malaria. Sci Rep 2023; 13:4760. [PMID: 36959462 PMCID: PMC10036474 DOI: 10.1038/s41598-023-31839-7] [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: 12/21/2022] [Accepted: 03/17/2023] [Indexed: 03/25/2023] Open
Abstract
Plasmodium knowlesi is the major cause of zoonotic malaria in Southeast Asia. Rapid and accurate diagnosis enables effective clinical management. A novel malaria diagnostic tool, Gazelle (Hemex Health, USA) detects haemozoin, a by-product of haem metabolism found in all Plasmodium infections. A pilot phase refined the Gazelle haemozoin identification algorithm, with the algorithm then tested against reference PCR in a larger cohort of patients with P. knowlesi mono-infections and febrile malaria-negative controls. Limit-of-detection analysis was conducted on a subset of P. knowlesi samples serially diluted with non-infected whole blood. The pilot phase of 40 P. knowlesi samples demonstrated 92.5% test sensitivity. P. knowlesi-infected patients (n = 203) and febrile controls (n = 44) were subsequently enrolled. Sensitivity and specificity of the Gazelle against reference PCR were 94.6% (95% CI 90.5-97.3%) and 100% (95% CI 92.0-100%) respectively. Positive and negative predictive values were 100% and 98.8%, respectively. In those tested before antimalarial treatment (n = 143), test sensitivity was 96.5% (95% CI 92.0-98.9%). Sensitivity for samples with ≤ 200 parasites/µL (n = 26) was 84.6% (95% CI 65.1-95.6%), with the lowest parasitaemia detected at 18/µL. Limit-of-detection (n = 20) was 33 parasites/µL (95% CI 16-65%). The Gazelle device has the potential for rapid, sensitive detection of P. knowlesi infections in endemic areas.
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Affiliation(s)
- Angelica F Tan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.
| | | | - Sitti Saimah Binti Sakam
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | - Yao Long Lew
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
- Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Bridget E Barber
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Steven Kho
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | | | - Matthew J Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.
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Paica IC, Rusu I, Popescu O, Brînzan A, Pencea I, Dobrinescu C, Kelemen B. Tentative indicators of malaria in archaeological skeletal samples, a pilot study testing different methods. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 40:109-116. [PMID: 36724549 DOI: 10.1016/j.ijpp.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study attempts to integrate multiple methods to investigate the presence of malaria in human skeletal samples from an archaeological context. MATERIALS 33 well preserved human remains originating from a 17th-century archaeological site in southeastern Romania. METHODS The human bone samples were analyzed using rapid diagnostic tests for malaria antigens and PCR amplification of Plasmodium falciparum apical membrane antigen 1. A preliminary test was performed to identify and briefly characterize the presence of hemozoin using a combination of TEM imaging and diffraction. RESULTS The rapid diagnostic tests indicated that more than half of the examined samples were positive for Plasmodium antigens, but no traces of the parasites' genetic material were detected despite repeated attempts. The TEM images indicated that hemozoin might be a promising diagnostic marker of malaria in ancient bones. CONCLUSIONS The indisputable identification of malaria in the analyzed archaeological population was not possible as none of the applied methodological strategies turned out to be straightforward. SIGNIFICANCE This study reinforces the intricacy and limitations of unequivocally identifying malaria in past populations and sets the stage for future studies on such life-threatening infectious disease in a geographical space, which is currently underrepresented in the bioarchaeological literature. LIMITATIONS The low sample size and the lack of consistency across all assays hindered understanding the role of malaria in the studied population. SUGGESTIONS FOR FURTHER RESEARCH Further thorough multidisciplinary approaches on malaria detection in ancient settlements would be appropriate to inform our knowledge of its origins, frequency, and pathogen changes over centuries.
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Affiliation(s)
| | - Ioana Rusu
- Department of Molecular Biology and Biotechnology, Faculty of Biology and Geology, Babeș-Bolyai University, Cluj-Napoca, 400006, Romania; Molecular Biology Centre, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babeș-Bolyai University, Cluj-Napoca, 400271, Romania.
| | - Octavian Popescu
- Institute of Biology Bucharest of Romanian Academy, Bucharest, 060031, Romania; Molecular Biology Centre, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babeș-Bolyai University, Cluj-Napoca, 400271, Romania; Emil G. Racoviță Institute, Babeș-Bolyai University, Cluj-Napoca, 400006, Romania
| | - Alexandru Brînzan
- Institute of Biology Bucharest of Romanian Academy, Bucharest, 060031, Romania
| | - Ion Pencea
- Department of Metallic Material Science and Physical Metallurgy, University Politehnica of Bucharest, Bucharest, 060042, Romania
| | - Cătălin Dobrinescu
- Department of Research-Development and Projects, Museum of National History and Archaeology, Constanţa, 900745, Romania
| | - Beatrice Kelemen
- Department of Molecular Biology and Biotechnology, Faculty of Biology and Geology, Babeș-Bolyai University, Cluj-Napoca, 400006, Romania; Molecular Biology Centre, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babeș-Bolyai University, Cluj-Napoca, 400271, Romania
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6
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Fernando D, Thota P, Semege S, Booso R, Bell D, de A. W. Gunasekera KT, Ranaweera P. Evaluation of a haemozoin-based rapid diagnostic test for diagnosis of imported malaria during the phase of prevention of reestablishment in Sri Lanka. Malar J 2022; 21:263. [PMID: 36088431 PMCID: PMC9464370 DOI: 10.1186/s12936-022-04283-7] [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: 04/21/2022] [Accepted: 08/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background Sri Lanka, an island nation, has eliminated endemic malaria transmission. Maintaining elimination in the continued presence of vectors requires vigilance in screening people travelling from high malaria-risk areas and a rapid response with focal screening for infections identified in the community. Such screening requires accurate and very rapid assays that enable an immediate response. Both microscopy and rapid diagnostic tests (RDTs) have limitations including sensitivity and speed in screening large numbers, while polymerase chain reaction (PCR) is practical only as laboratory confirmation. This study assessed the utility of ‘Gazelle’, a novel rapid malaria assay based on magneto-optical detection of haemozoin, a by-product of malaria parasite metabolism. Methods Between October 2020 and March 2021, two groups of individuals were screened for malaria by four methods, namely, microscopy, Rapid Diagnostic Test (RDT), Gazelle and PCR. Passive case detection was carried out for confirmation of diagnosis amongst individuals suspected of having malaria. Individuals at high-risk of acquiring malaria, namely persons returning from malaria endemic countries, were screened by active case detection. Results Of the 440 individuals screened for malaria, nine malaria positives were diagnosed by PCR, microscopy and the HRP2 band of RDT, which included five Plasmodium falciparum infections, two Plasmodium ovale, and one each of Plasmodium vivax and Plasmodium malariae. Gazelle correctly detected the P. vivax, P. ovale and P. malariae infections within the 2 min test time, but did not detect two P. falciparum infections giving a sensitivity of 77.8%. Specificity was 100%. Discussion The Gazelle, a portable bench top device proved useful to screen a large number of blood samples for non-falciparum parasites within 5 minutes of sample input. Species differentiation, and improvement in P. falciparum detection, will be important to broaden utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04283-7.
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7
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Veettil TCP, Kochan K, Edler KJ, De Bank P, Heraud P, Wood BR. Disposable Coverslip for Rapid Throughput Screening of Malaria Using Attenuated Total Reflection Spectroscopy. APPLIED SPECTROSCOPY 2022; 76:451-461. [PMID: 33876968 DOI: 10.1177/00037028211012722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Malaria is considered to be one of the most catastrophic health issues in the whole world. Vibrational spectroscopy is a rapid, robust, label-free, inexpensive, highly sensitive, nonperturbative, and nondestructive technique with high diagnostic potential for the early detection of disease agents. In particular, the fingerprinting capability of attenuated total reflection spectroscopy is promising as a point-of-care diagnostic tool in resource-limited areas. However, improvements are required to expedite the measurements of biofluids, including the drying procedure and subsequent cleaning of the internal reflection element to enable high throughput successive measurements. As an alternative, we propose using an inexpensive coverslip to reduce the sample preparation time by enabling multiple samples to be collectively dried together under the same temperature and conditions. In conjunction with partial least squares regression, attenuated total reflection spectroscopy was able to detect and quantify the parasitemia with root mean square error of cross-validation and R2 values of 0.177 and 0.985, respectively. Here, we characterize an inexpensive, disposable coverslip for the high throughput screening of malaria parasitic infections and thus demonstrate an alternative approach to direct deposition of the sample onto the internal reflection element.
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Affiliation(s)
| | - Kamila Kochan
- Centre for Biospectroscopy and School of Chemistry, 2541Monash University, Clayton, Australia
| | - Karen J Edler
- Department of Chemistry, 1555University of Bath, Bath, UK
| | - Paul De Bank
- Department of Pharmacy and Pharmacology, 1555University of Bath, Bath, UK
| | - Philip Heraud
- Centre for Biospectroscopy and School of Chemistry, 2541Monash University, Clayton, Australia
| | - Bayden R Wood
- Centre for Biospectroscopy and School of Chemistry, 2541Monash University, Clayton, Australia
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Baptista V, Costa MS, Calçada C, Silva M, Gil JP, Veiga MI, Catarino SO. The Future in Sensing Technologies for Malaria Surveillance: A Review of Hemozoin-Based Diagnosis. ACS Sens 2021; 6:3898-3911. [PMID: 34735120 DOI: 10.1021/acssensors.1c01750] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Early and effective malaria diagnosis is vital to control the disease spread and to prevent the emergence of severe cases and death. Currently, malaria diagnosis relies on optical microscopy and immuno-rapid tests; however, these require a drop of blood, are time-consuming, or are not specific and sensitive enough for reliable detection of low-level parasitaemia. Thus, there is an urge for simpler, prompt, and accurate alternative diagnostic methods. Particularly, hemozoin has been increasingly recognized as an attractive biomarker for malaria detection. As the disease proliferates, parasites digest host hemoglobin, in the process releasing toxic haem that is detoxified into an insoluble crystal, the hemozoin, which accumulates along with infection progression. Given its magnetic, optical, and acoustic unique features, hemozoin has been explored for new label-free diagnostic methods. Thereby, herein, we review the hemozoin-based malaria detection methods and critically discuss their challenges and potential for the development of an ideal diagnostic device.
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Affiliation(s)
- Vitória Baptista
- Microelectromechanical Systems Research Unit (CMEMS-UMinho), School of Engineering, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s − PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Mariana S. Costa
- Microelectromechanical Systems Research Unit (CMEMS-UMinho), School of Engineering, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
| | - Carla Calçada
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s − PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
| | - Miguel Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s − PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - José Pedro Gil
- Stockholm Malaria Center, Department of Microbiology and Tumour Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Maria Isabel Veiga
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s − PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Susana O. Catarino
- Microelectromechanical Systems Research Unit (CMEMS-UMinho), School of Engineering, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
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9
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Orbán Á, Longley RJ, Sripoorote P, Maneechai N, Nguitragool W, Butykai Á, Mueller I, Sattabongkot J, Karl S, Kézsmárki I. Sensitive detection of Plasmodium vivax malaria by the rotating-crystal magneto-optical method in Thailand. Sci Rep 2021; 11:18547. [PMID: 34535695 PMCID: PMC8448879 DOI: 10.1038/s41598-021-97532-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022] Open
Abstract
The rotating-crystal magneto-optical detection (RMOD) method has been developed for the rapid and quantitative diagnosis of malaria and tested systematically on various malaria infection models. Very recently, an extended field trial in a high-transmission region of Papua New Guinea demonstrated its great potential for detecting malaria infections, in particular Plasmodium vivax. In the present small-scale field test, carried out in a low-transmission area of Thailand, RMOD confirmed malaria in all samples found to be infected with Plasmodium vivax by microscopy, our reference method. Moreover, the magneto-optical signal for this sample set was typically 1–3 orders of magnitude higher than the cut-off value of RMOD determined on uninfected samples. Based on the serial dilution of the original patient samples, we expect that the method can detect Plasmodium vivax malaria in blood samples with parasite densities as low as \documentclass[12pt]{minimal}
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\begin{document}$$\sim$$\end{document}∼5–10 parasites per microliter, a limit around the pyrogenic threshold of the infection. In addition, by investigating the correlation between the magnitude of the magneto-optical signal, the parasite density and the erythrocytic stage distribution, we estimate the relative hemozoin production rates of the ring and the trophozoite stages of in vivo Plasmodium vivax infections.
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Affiliation(s)
- Ágnes Orbán
- Department of Physics, Budapest University of Technology and Economics, Budapest, Hungary.
| | - Rhea J Longley
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.,Mahidol Vivax Research Unit, Mahidol University, Bangkok, Thailand.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Wang Nguitragool
- Department of Molecular Tropical Medicine and Genetics, Mahidol University, Bangkok, Thailand
| | - Ádám Butykai
- Department of Physics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Ivo Mueller
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia.,Unité Malaria: Parasites et Hôtes, Département Parasites et Insectes Vecteurs, Institut Pasteur, Paris, France
| | | | - Stephan Karl
- Vector-borne Diseases Unit, PNG Institute of Medical Research, Madang, Madang Province 511, Papua New Guinea.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLD, Australia
| | - István Kézsmárki
- Department of Physics, Budapest University of Technology and Economics, Budapest, Hungary.,Experimental Physics 5, Center for Electronic Correlations and Magnetism, University of Augsburg, Augsburg, Germany
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10
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Kara D, Deissler RJ, Al Helo R, Blasinsky K, Grimberg BT, Brown R. An ON-OFF Magneto-Optical Probe of Anisotropic Biofluid Crystals: A β-Hematin Case Study. IEEE TRANSACTIONS ON MAGNETICS 2021; 57:5200211. [PMID: 35813117 PMCID: PMC9268508 DOI: 10.1109/tmag.2021.3096046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We have designed, developed and evaluated an innovative portable magneto-optical detector (MOD) in which a light beam with variable polarization passes through a fluid sample immersed in a variable magnetic field. The light intensity is measured downstream along the forward scattering direction. The field is turned on and off through the in-and-out motion of nearby permanent magnets. As a result, for sufficiently magnetically and optically anisotropic samples, the optical absorption is sensitive to changes in the light polarization. Both detection and characterization applications are therefore available. For instance, both the degree of malaria infection can be measured and hemozoin crystalline properties can be studied. We present experimental results for synthetic hemozoin, and describe them in terms of the basic physics and chemistry underlying the correlations of the directions of the external magnetic field and the light beam polarization. We connect this work to a commercialized product for malaria detection and compare it to other magneto-optical instruments and methods. We conduct tests of absorption parameters, the electric polarizability tensor, and we discuss the connection to magnetic and electric dipole moments.
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Affiliation(s)
- Danielle Kara
- Department of Physics, John Carroll University, University Heights, OH, 44118, USA
| | - Robert J. Deissler
- Department of Physics, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Rose Al Helo
- Department of Physics, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Kyle Blasinsky
- Department of Physics, John Carroll University, University Heights, OH, 44118, USA
| | - Brian T. Grimberg
- Center for Global Health & Diseases, Department of Pathology, Case, Western Reserve University, Cleveland, OH 44106, USA
| | - Robert Brown
- Department of Physics, Case Western Reserve University, Cleveland, OH, 44106, USA
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Field validation of a magneto-optical detection device (Gazelle) for portable point-of-care Plasmodium vivax diagnosis. PLoS One 2021; 16:e0253232. [PMID: 34157032 PMCID: PMC8219132 DOI: 10.1371/journal.pone.0253232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/31/2021] [Indexed: 12/17/2022] Open
Abstract
A major challenge for malaria is the lack of tools for accurate and timely diagnosis in the field which are critical for case management and surveillance. Microscopy along with rapid diagnostic tests are the current mainstay for malaria diagnosis in most endemic regions. However, these methods present several limitations. This study assessed the accuracy of Gazelle, a novel rapid malaria diagnostic device, from samples collected from the Peruvian Amazon between 2019 and 2020. Diagnostic accuracy was compared against microscopy and two rapid diagnostic tests (SD Bioline and BinaxNOW) using 18ssr nested-PCR as reference test. In addition, a real-time PCR assay (PET-PCR) was used for parasite quantification. Out of 217 febrile patients enrolled and tested, 180 specimens (85 P. vivax and 95 negatives) were included in the final analysis. Using nested-PCR as the gold standard, the sensitivity and specificity of Gazelle was 88.2% and 97.9%, respectively. Using a cutoff of 200 parasites/μl, Gazelle’s sensitivity for samples with more than 200 p/uL was 98.67% (95%CI: 92.79% to 99.97%) whereas the sensitivity for samples lower than 200 p/uL (n = 10) was 12.5% (95%CI: 0.32% to 52.65%). Gazelle’s sensitivity and specificity were statistically similar to microscopy (sensitivity = 91.8, specificity = 100%, p = 0.983) and higher than both SD Bioline (sensitivity = 82.4, specificity = 100%, p = 0.016) and BinaxNOW (sensitivity = 71.8%, specificity = 97.9%, p = 0.002). The diagnostic accuracy of Gazelle for malaria detection in P. vivax infections was comparable to light microscopy and superior to both RDTs even in the presence of low parasitemia infections. The performance of Gazelle makes it a valuable tool for malaria diagnosis and active case detection that can be utilized in different malaria-endemic regions.
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12
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de Melo GC, Netto RLA, Mwangi VI, Salazar YEAR, de Souza Sampaio V, Monteiro WM, de Almeida E Val FF, Rocheleau A, Thota P, Lacerda MVG. Performance of a sensitive haemozoin-based malaria diagnostic test validated for vivax malaria diagnosis in Brazilian Amazon. Malar J 2021; 20:146. [PMID: 33712019 PMCID: PMC7953757 DOI: 10.1186/s12936-021-03688-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/05/2021] [Indexed: 01/20/2023] Open
Abstract
Background Vivax malaria diagnosis remains a challenge in malaria elimination, with current point of care rapid diagnostic tests (RDT) missing many clinically significant infections because of usually lower peripheral parasitaemia. Haemozoin-detecting assays have been suggested as an alternative to immunoassay platforms but to date have not reached successful field deployment. Haemozoin is a paramagnetic crystal by-product of haemoglobin digestion by malaria parasites and is present in the food vacuole of malaria parasite-infected erythrocytes. This study aimed to compare the diagnostic capability of a new haemozoin-detecting platform, the Gazelle™ device with optical microscopy, RDT and PCR in a vivax malaria-endemic region. Methods A comparative, double-blind study evaluating symptomatic malaria patients seeking medical care was conducted at an infectious diseases reference hospital in the western Brazilian Amazon. Optical microscopy, PCR, RDT, and Gazelle™ were used to analyse blood samples. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa values were calculated. Results Out of 300 patients, 24 test results were excluded from the final analysis due to protocol violation (6) and inconclusive and/or irretrievable results (18). Gazelle™ sensitivity was 96.1 % (91.3–98.3) and 72.1 % (65.0–78.3) when compared to optical microscopy and PCR, respectively whereas it was 83.9 % and 62.8 % for RDTs. The platform presented specificity of 100 % (97.4–100), and 99.0 % (94.8–99.9) when compared to optical microscopy, and PCR, respectively, which was the same for RDTs. Its correct classification rate was 98.2 % when compared to optical microscopy and 82.3 % for PCR; the test’s accuracy when compared to optical microscopy was 98.1 % (96.4–99.7), when compared to RDT was 95.2 % (93.0–97.5), and when compared to PCR was 85.6 % (82.1–89.1). Kappa (95 % CI) values for Gazelle™ were 96.4 (93.2–99.5), 88.2 (82.6–93.8) and 65.3 (57.0–73.6) for optical microscopy, RDT and PCR, respectively. Conclusions The Gazelle™ device was shown to have faster, easier, good sensitivity, specificity, and accuracy when compared to microscopy and was superior to RDT, demonstrating to be an alternative for vivax malaria screening particularly in areas where malaria is concomitant with other febrile infections (including dengue fever, zika, chikungunya, Chagas, yellow fever, babesiosis).
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Affiliation(s)
- Gisely Cardoso de Melo
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil. .,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil.
| | | | - Victor Irungu Mwangi
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil
| | | | - Vanderson de Souza Sampaio
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil.,Fundação de Vigilância em Saúde (FVS) - Manaus, Manaus, Amazonas, 69093-018, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil
| | - Fernando Fonseca de Almeida E Val
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil
| | - Anne Rocheleau
- Hemex Health, 4640 SW Macadam Avenue, Suite 250 , Portland, Oregon, 97239, USA
| | - Priyaleela Thota
- Hemex Health, 4640 SW Macadam Avenue, Suite 250 , Portland, Oregon, 97239, USA
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, 69040-000, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, 69040-000, Brazil.,Instituto Leônidas & Maria Deane (ILMD) Fiocruz, Manaus, Amazonas, 69057-070, Brazil
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13
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Magneto-optical diagnosis of symptomatic malaria in Papua New Guinea. Nat Commun 2021; 12:969. [PMID: 33579923 PMCID: PMC7881035 DOI: 10.1038/s41467-021-21110-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 11/20/2022] Open
Abstract
Improved methods for malaria diagnosis are urgently needed. Here, we evaluate a novel method named rotating-crystal magneto-optical detection (RMOD) in 956 suspected malaria patients in Papua New Guinea. RMOD tests can be conducted within minutes and at low cost. We systematically evaluate the capability of RMOD to detect infections by directly comparing it with expert light microscopy, rapid diagnostic tests and polymerase chain reaction on capillary blood samples. We show that compared to light microscopy, RMOD exhibits 82% sensitivity and 84% specificity to detect any malaria infection and 87% sensitivity and 88% specificity to detect Plasmodium vivax. This indicates that RMOD could be useful in P. vivax dominated elimination settings. Parasite density correlates well with the quantitative magneto-optical signal. Importantly, residual hemozoin present in malaria-negative patients is also detectable by RMOD, indicating its ability to detect previous infections. This could be exploited to reveal transmission hotspots in low-transmission settings. Here Arndt et al. establish rotating-crystal magneto-optical detection (RMOD) as a near-point-of-care diagnostic tool for malaria detection and report a sensitivity and specificity of 82% and 84%, respectively, as validated by analyzing a clinical population in a high transmission setting in Papua New Guinea.
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14
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Dharap P, Raimbault S. Performance evaluation of machine learning-based infectious screening flags on the HORIBA Medical Yumizen H550 Haematology Analyzer for vivax malaria and dengue fever. Malar J 2020; 19:429. [PMID: 33228680 PMCID: PMC7684750 DOI: 10.1186/s12936-020-03502-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Automated detection of malaria and dengue infection has been actively researched for more than two decades. Although many improvements have been achieved, these solutions remain too expensive for most laboratories and clinics in developing countries. The low range HORIBA Medical Haematology Analyzer, Yumizen H550, now provides dedicated flags 'vivax malaria' and 'dengue fever' in routine blood testing, developed through machine learning methods, to be used as a screening tool for malaria and dengue fever in endemic areas. This study sought to evaluate the effectiveness of these flags under real clinical conditions. METHODS A total of 1420 samples were tested using the Yumizen H550 Haematology Analyzer, including 1339 samples from febrile patients among whom 202 were infected with malaria parasites (Plasmodium vivax only: 182, Plasmodium falciparum only: 18, both: 2), 210 were from febrile dengue infected patients, 3 were from afebrile dengue infected patients and 78 were samples from healthy controls, in an outpatient laboratory clinic in Mumbai, India. Microscopic examination was carried out as the confirmatory reference method for detection of malarial parasite, species identification and assessing parasitaemia based on different stages of parasite life cycle. Rapid diagnostic malarial antigen tests were used for additional confirmation. For dengue infection, NS1 antigen detection by ELISA was used as a diagnostic marker. RESULTS For the automated vivax malaria flag, the original manufacturer's cut off yielded a sensitivity and specificity of 65.2% and 98.9% respectively with the ROC AUC of 0.9. After optimization of cut-off value, flag performance improved to 72% for sensitivity and 97.9% specificity. Additionally it demonstrated a positive correlation with increasing levels of parasitaemia. For the automated dengue fever flag it yielded a ROC AUC of 0.82 with 79.3% sensitivity and 71.5% specificity. CONCLUSIONS The results demonstrate a possibility of the effective use of automated infectious flags for screening vivax malaria and dengue infection in a clinical setting.
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15
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Traore O, Compaore M, Okusa P, Hubinon F, Duez P, Blankert B, Kindrebeogo M. Development and validation of an original magneto-chromatography device for the whole blood determination of hemozoin, the paramagnetic malaria pigment. Microchem J 2020. [DOI: 10.1016/j.microc.2020.105043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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16
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Kumar R, Verma AK, Shrivas S, Thota P, Singh MP, Rajasubramaniam S, Das A, Bharti PK. First successful field evaluation of new, one-minute haemozoin-based malaria diagnostic device. EClinicalMedicine 2020; 22:100347. [PMID: 32490369 PMCID: PMC7256309 DOI: 10.1016/j.eclinm.2020.100347] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/21/2020] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Early and accurate diagnosis of malaria is critical to the success of malaria elimination. However, the current mainstay of malaria diagnosis in the field, such as light microscopy and rapid diagnostic tests (RDTs), have limitations due to low parasite density or mutation in diagnostic markers. METHODS We evaluated an inexpensive, robust, rapid, malaria diagnostic device, called Gazelle, that employs magneto-optical detection to identify haemozoin crystals (Hz) produced by all species of human malaria parasites in infected individuals. A beam of polarised light is passed through the lysed diluted blood sample under the influence of high (~.55T) and low magnetic fields. The difference in light transmission through the sample between the high and low magnetic fields indicates presence of Hz, suggesting possible malarial infection. A total of 300 febrile patients were screened at the malaria clinic of Indian Council of Medical Research-National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, India, from August 2018 to November 2018. Malaria diagnosis was done using four diagnostic methods: Gazelle, light microscopy, RDT, and malaria specific Polymerase Chain Reaction (PCR). Measures of diagnostic accuracy were compared. FINDINGS Out of 300 febrile patients enroled and tested for the presence of malaria parasites, 262 patient samples were included in the final analysis. The sensitivity and specificity of Gazelle was 98% and 97% in comparison to light microscopy, 82% and 99% to PCR and 78% and 99% to RDT, respectively. The results of the four diagnostic methods were comparable and statistically no significant differences in sensitivity or specificity was observed between these methods. Enhanced diagnostic accuracy of Gazelle in malaria patients with no prior history of malaria treatment was observed in this study. INTERPRETATION The diagnostic ability of Gazelle was comparable to light microscopy and better than RDTs even in low parasitemia and in presence of pfhrp2/3 deletion mutant parasites. Gazelle may be a novel valuable diagnostic tool in resource poor settings where (i) microscopy is not feasible and (ii) pfhrp2/3gene deleted parasite are present. Its speed, cost-efficiency, and alternative to lack of microscopists makes it an important adjunct in field settings. FUNDING HemexDx, India.
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Affiliation(s)
- Rajat Kumar
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
| | - Anil K. Verma
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
| | - Shweta Shrivas
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
| | | | - Mrigendra P. Singh
- National Institute of Malaria Research-Field station (NIMR-FS), Jabalpur, Madhya Pradesh, India
| | - S. Rajasubramaniam
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
| | - Praveen K. Bharti
- ICMR-National Institute of Research in Tribal Health (NIRTH), Jabalpur, Madhya Pradesh, India
- Corresponding author.
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17
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Highly Sensitive and Rapid Characterization of the Development of Synchronized Blood Stage Malaria Parasites Via Magneto-Optical Hemozoin Quantification. Biomolecules 2019; 9:biom9100579. [PMID: 31591333 PMCID: PMC6843464 DOI: 10.3390/biom9100579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/23/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023] Open
Abstract
The rotating-crystal magneto-optical diagnostic (RMOD) technique was developed as a sensitive and rapid platform for malaria diagnosis. Herein, we report a detailed in vivo assessment of the synchronized Plasmodium vinckei lentum strain blood-stage infections by the RMOD method and comparing the results to the unsynchronized Plasmodium yoelii 17X-NL (non-lethal) infections. Furthermore, we assess the hemozoin production and clearance dynamics in chloroquine-treated compared to untreated self-resolving infections by RMOD. The findings of the study suggest that the RMOD signal is directly proportional to the hemozoin content and closely follows the actual parasitemia level. The lack of long-term accumulation of hemozoin in peripheral blood implies a dynamic equilibrium between the hemozoin production rate of the parasites and the immune system’s clearing mechanism. Using parasites with synchronous blood stage cycle, which resemble human malaria parasite infections with Plasmodium falciparum and Plasmodium vivax, we are demonstrating that the RMOD detects both hemozoin production and clearance rates with high sensitivity and temporal resolution. Thus, RMOD technique offers a quantitative tool to follow the maturation of the malaria parasites even on sub-cycle timescales.
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18
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Fescenko I, Laraoui A, Smits J, Mosavian N, Kehayias P, Seto J, Bougas L, Jarmola A, Acosta VM. Diamond Magnetic Microscopy of Malarial Hemozoin Nanocrystals. PHYSICAL REVIEW APPLIED 2019; 11:034029. [PMID: 31245433 PMCID: PMC6594715 DOI: 10.1103/physrevapplied.11.034029] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Magnetic microscopy of malarial hemozoin nanocrystals is performed by optically detected magnetic resonance imaging of near-surface diamond nitrogen-vacancy centers. Hemozoin crystals are extracted from Plasmodium falciparum-infected human blood cells and studied alongside synthetic hemozoin crystals. The stray magnetic fields produced by individual crystals are imaged at room temperature as a function of the applied field up to 350 mT. More than 100 nanocrystals are analyzed, revealing the distribution of their magnetic properties. Most crystals (96%) exhibit a linear dependence of the stray-field magnitude on the applied field, confirming hemozoin's paramagnetic nature. A volume magnetic susceptibility of 3.4 × 10-4 is inferred with use of a magnetostatic model informed by correlated scanning-electron-microscopy measurements of crystal dimensions. A small fraction of nanoparticles (4/82 for Plasmodium falciparum-produced nanoparticles and 1/41 for synthetic nanoparticles) exhibit a saturation behavior consistent with superparamagnetism. Translation of this platform to the study of living Plasmodium-infected cells may shed new light on hemozoin formation dynamics and their interaction with antimalarial drugs.
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Affiliation(s)
- Ilja Fescenko
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
| | - Abdelghani Laraoui
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
| | - Janis Smits
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
- Laser Centre of the University of Latvia, Jelgavas street
3, Riga, LV-1004, Latvia
| | - Nazanin Mosavian
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
| | - Pauli Kehayias
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
- Department of Physics, Harvard University, 17 Oxford St,
Cambridge, 02138 Massachusetts, USA
| | - Jong Seto
- Department of Bioengineering and Therapeutic Sciences,
School of Medicine, University of California-San Francisco, 1700 4th St, San
Francisco, 94158 California, USA
| | - Lykourgos Bougas
- Johannes Guttenberg University, Saarstraße 21, 55128
Mainz, Germany
| | - Andrey Jarmola
- Department of Physics, University of California, Berkeley,
366 LeConte Hall, Berkeley, 94720 California, USA
- ODMR Technologies Inc., 2041 Tapscott Ave, El Cerrito,
94530 California, USA
| | - Victor M. Acosta
- Center for High Technology Materials and Department of
Physics and Astronomy,University of New Mexico, 1313 Goddard St SE, Albuquerque,
87106 New Mexico, USA
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19
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Markwalter C, Kantor AG, Moore CP, Richardson KA, Wright DW. Inorganic Complexes and Metal-Based Nanomaterials for Infectious Disease Diagnostics. Chem Rev 2019; 119:1456-1518. [PMID: 30511833 PMCID: PMC6348445 DOI: 10.1021/acs.chemrev.8b00136] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Indexed: 12/12/2022]
Abstract
Infectious diseases claim millions of lives each year. Robust and accurate diagnostics are essential tools for identifying those who are at risk and in need of treatment in low-resource settings. Inorganic complexes and metal-based nanomaterials continue to drive the development of diagnostic platforms and strategies that enable infectious disease detection in low-resource settings. In this review, we highlight works from the past 20 years in which inorganic chemistry and nanotechnology were implemented in each of the core components that make up a diagnostic test. First, we present how inorganic biomarkers and their properties are leveraged for infectious disease detection. In the following section, we detail metal-based technologies that have been employed for sample preparation and biomarker isolation from sample matrices. We then describe how inorganic- and nanomaterial-based probes have been utilized in point-of-care diagnostics for signal generation. The following section discusses instrumentation for signal readout in resource-limited settings. Next, we highlight the detection of nucleic acids at the point of care as an emerging application of inorganic chemistry. Lastly, we consider the challenges that remain for translation of the aforementioned diagnostic platforms to low-resource settings.
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Affiliation(s)
| | | | | | | | - David W. Wright
- Department of Chemistry, Vanderbilt
University, Nashville, Tennessee 37235, United States
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20
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Turning Plasmodium survival strategies against itself. Future Med Chem 2018; 10:2245-2248. [PMID: 30215274 DOI: 10.4155/fmc-2018-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Pham NM, Karlen W, Beck HP, Delamarche E. Malaria and the 'last' parasite: how can technology help? Malar J 2018; 17:260. [PMID: 29996831 PMCID: PMC6042346 DOI: 10.1186/s12936-018-2408-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/03/2018] [Indexed: 01/09/2023] Open
Abstract
Malaria, together with HIV/AIDS, tuberculosis and hepatitis are the four most deadly infectious diseases globally. Progress in eliminating malaria has saved millions of lives, but also creates new challenges in detecting the 'last parasite'. Effective and accurate detection of malaria infections, both in symptomatic and asymptomatic individuals are needed. In this review, the current progress in developing new diagnostic tools to fight malaria is presented. An ideal rapid test for malaria elimination is envisioned with examples to demonstrate how innovative technologies can assist the global defeat against this disease. Diagnostic gaps where technology can bring an impact to the elimination campaign for malaria are identified. Finally, how a combination of microfluidic-based technologies and smartphone-based read-outs could potentially represent the next generation of rapid diagnostic tests is discussed.
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Affiliation(s)
- Ngoc Minh Pham
- Department of Health Sciences and Technology, ETH Zürich, Lengghalde 5, 8092, Zurich, Switzerland
| | - Walter Karlen
- Department of Health Sciences and Technology, ETH Zürich, Lengghalde 5, 8092, Zurich, Switzerland
| | - Hans-Peter Beck
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland.
- University of Basel, Petersgraben 1, 4001, Basel, Switzerland.
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Gilson RC, Deissler RJ, Bihary RF, Condit WC, Thompson ME, Blankenship D, Grimberg KO, Brown RW, Grimberg BT. Growth of Plasmodium falciparum in response to a rotating magnetic field. Malar J 2018; 17:190. [PMID: 29724219 PMCID: PMC5934852 DOI: 10.1186/s12936-018-2333-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/25/2018] [Indexed: 02/08/2023] Open
Abstract
Background Plasmodium falciparum is the deadliest strain of malaria and the mortality rate is increasing because of pathogen drug resistance. Increasing knowledge of the parasite life cycle and mechanism of infection may provide new models for improved treatment paradigms. This study sought to investigate the paramagnetic nature of the parasite’s haemozoin to inhibit parasite viability. Results Paramagnetic haemozoin crystals, a byproduct of the parasite’s haemoglobin digestion, interact with a rotating magnetic field, which prevents their complete formation, causing the accumulation of free haem, which is lethal to the parasites. Plasmodium falciparum cultures of different stages of intraerythrocytic growth (rings, trophozoites, and schizonts) were exposed to a magnetic field of 0.46 T at frequencies of 0 Hz (static), 1, 5, and 10 Hz for 48 h. The numbers of parasites were counted over the course of one intraerythrocytic life cycle via flow cytometry. At 10 Hz the schizont life stage was most affected by the rotating magnetic fields (p = 0.0075) as compared to a static magnetic field of the same strength. Parasite growth in the presence of a static magnetic field appears to aid parasite growth. Conclusions Sequestration of the toxic haem resulting from haemoglobin digestion is key for the parasites’ survival and the focus of almost all existing anti-malarial drugs. Understanding how the parasites create the haemozoin molecule and the disruption of its creation aids in the development of drugs to combat this disease.
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Affiliation(s)
- Rebecca C Gilson
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA.,Department of Pathology, Center for Global Health and Diseases, Biomedical Research Building, Room 427, 2109 Adelbert Road, Cleveland, OH, 44106, USA
| | - Robert J Deissler
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA
| | - Richard F Bihary
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA
| | - William C Condit
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA
| | - Mary E Thompson
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA
| | - D'Arbra Blankenship
- Department of Pathology, Center for Global Health and Diseases, Biomedical Research Building, Room 427, 2109 Adelbert Road, Cleveland, OH, 44106, USA
| | - Kerry O Grimberg
- Department of Pathology, Center for Global Health and Diseases, Biomedical Research Building, Room 427, 2109 Adelbert Road, Cleveland, OH, 44106, USA
| | - Robert W Brown
- Department of Physics, CWRU College of Arts and Sciences, 2076 Adelbert Road, Cleveland, OH, 44106-7079, USA
| | - Brian T Grimberg
- Department of Pathology, Center for Global Health and Diseases, Biomedical Research Building, Room 427, 2109 Adelbert Road, Cleveland, OH, 44106, USA.
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Abbas M, Bossis G. Separation of two attractive ferromagnetic ellipsoidal particles by hydrodynamic interactions under alternating magnetic field. Phys Rev E 2017; 95:062611. [PMID: 28709332 DOI: 10.1103/physreve.95.062611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Indexed: 06/07/2023]
Abstract
In applications where magnetic particles are used to detect and dose targeted molecules, it is of major importance to prevent particle clustering and aggregation during the capture stage in order to maximize the capture rate. Elongated ferromagnetic particles can be more interesting than spherical ones due to their large magnetic moment, which facilitates their separation by magnets or the detection by optical measurement of their orientation relaxation time. Under alternating magnetic field, the rotational dynamics of elongated ferromagnetic particles results from the balance between magnetic torque that tends to align the particle axis with the field direction and viscous torque. As for their translational motion, it results from a competition between direct magnetic particle-particle interactions and solvent-flow-mediated hydrodynamic interactions. Due to particle anisotropy, this may lead to intricate translation-rotation couplings. Using numerical simulations and theoretical modeling of the system, we show that two ellipsoidal magnetic particles, initially in a head-to-tail attractive configuration resulting from their remnant magnetization, can repel each other due to hydrodynamic interactions when alternating field is operated. The separation takes place in a range of low frequencies f_{c1}<f<f_{c2}. The upper frequency limit f_{c2}τ_{r}≈0.04 (where τ_{r} is the rotation time scale) depends weakly on the ratio of magnetic field to particle magnetization strength, whereas f_{c1} tends to zero when this ratio increases.
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Affiliation(s)
- Micheline Abbas
- Laboratoire de Génie Chimique, Université de Toulouse, CNRS, INPT, UPS, Toulouse, France
| | - Georges Bossis
- Laboratoire de Physique de la Matière Condensée, Nice, France
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Grimberg BT, Grimberg KO. Hemozoin detection may provide an inexpensive, sensitive, 1-minute malaria test that could revolutionize malaria screening. Expert Rev Anti Infect Ther 2016; 14:879-83. [PMID: 27530228 PMCID: PMC5224914 DOI: 10.1080/14787210.2016.1222900] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 08/08/2016] [Indexed: 12/25/2022]
Abstract
Malaria remains widespread throughout the tropics and is a burden to the estimated 3.5 billion people who are exposed annually. The lack of a fast and accurate diagnostic method contributes to preventable malaria deaths and its continued transmission. In many areas diagnosis is made solely based on clinical presentation. Current methods for malaria diagnosis take more than 20 minutes from the time blood is drawn and are frequently inaccurate. The introduction of an accurate malaria diagnostic that can provide a result in less than 1 minute would allow for widespread screening and treatment of endemic populations, and enable regions that have gained a foothold against malaria to prevent its return. Using malaria parasites' waste product, hemozoin, as a biomarker for the presence of malaria could be the tool needed to develop this rapid test.
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Affiliation(s)
- Brian T Grimberg
- a School of Medicine - Center for Global Health and Diseases , Case Western Reserve University , Cleveland , OH , USA
| | - Kerry O Grimberg
- b School of Medicine, Department of Radiology , Case Western Reserve University , Cleveland , OH , USA
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Kasetsirikul S, Buranapong J, Srituravanich W, Kaewthamasorn M, Pimpin A. The development of malaria diagnostic techniques: a review of the approaches with focus on dielectrophoretic and magnetophoretic methods. Malar J 2016; 15:358. [PMID: 27405995 PMCID: PMC4942956 DOI: 10.1186/s12936-016-1400-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 06/17/2016] [Indexed: 11/10/2022] Open
Abstract
The large number of deaths caused by malaria each year has increased interest in the development of effective malaria diagnoses. At the early-stage of infection, patients show non-specific symptoms or are asymptomatic, which makes it difficult for clinical diagnosis, especially in non-endemic areas. Alternative diagnostic methods that are timely and effective are required to identify infections, particularly in field settings. This article reviews conventional malaria diagnostic methods together with recently developed techniques for both malaria detection and infected erythrocyte separation. Although many alternative techniques have recently been proposed and studied, dielectrophoretic and magnetophoretic approaches are among the promising new techniques due to their high specificity for malaria parasite-infected red blood cells. The two approaches are discussed in detail, including their principles, types, applications and limitations. In addition, other recently developed techniques, such as cell deformability and morphology, are also overviewed in this article.
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Affiliation(s)
- Surasak Kasetsirikul
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Jirayut Buranapong
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Werayut Srituravanich
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Morakot Kaewthamasorn
- Animal Vector-Borne Diseases Research Group, The Veterinary Parasitology Unit, Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Alongkorn Pimpin
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, 10330, Thailand.
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Rebelo M, Grenho R, Orban A, Hänscheid T. Transdermal Diagnosis of Malaria Using Vapor Nanobubbles. Emerg Infect Dis 2016; 22:343-4. [PMID: 26811926 PMCID: PMC4734514 DOI: 10.3201/eid2202.151203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Efficient monitoring of the blood-stage infection in a malaria rodent model by the rotating-crystal magneto-optical method. Sci Rep 2016; 6:23218. [PMID: 26983695 PMCID: PMC4794716 DOI: 10.1038/srep23218] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/26/2016] [Indexed: 11/29/2022] Open
Abstract
Intense research efforts have been focused on the improvement of the efficiency and sensitivity of malaria diagnostics, especially in resource-limited settings for the detection of asymptomatic infections. Our recently developed magneto-optical (MO) method allows the accurate quantification of malaria pigment crystals (hemozoin) in blood by their magnetically induced rotation. First evaluations of the method using β-hematin crystals and in vitro P. falciparum cultures implied its potential for high-sensitivity malaria diagnosis. To further investigate this potential, here we study the performance of the method in monitoring the in vivo onset and progression of the blood-stage infection in a rodent malaria model. Our results show that the MO method can detect the first generation of intraerythrocytic P. berghei parasites 66–76 hours after sporozoite injection, demonstrating similar sensitivity to Giesma-stained light microscopy and exceeding that of flow cytometric techniques. Magneto-optical measurements performed during and after the treatment of P. berghei infections revealed that both the follow up under treatment and the detection of later reinfections are feasible with this new technique. The present study demonstrates that the MO method – besides being label and reagent-free, automated and rapid – has a high in vivo sensitivity and is ready for in-field evaluation.
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Lukianova-Hleb E, Bezek S, Szigeti R, Khodarev A, Kelley T, Hurrell A, Berba M, Kumar N, D'Alessandro U, Lapotko D. Transdermal Diagnosis of Malaria Using Vapor Nanobubbles. Emerg Infect Dis 2016; 21:1122-7. [PMID: 26079141 PMCID: PMC4480396 DOI: 10.3201/eid2107.150089] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Our laser device rapidly and noninvasively detected malaria in a patient and identified parasite-positive mosquitoes. A fast, precise, noninvasive, high-throughput, and simple approach for detecting malaria in humans and mosquitoes is not possible with current techniques that depend on blood sampling, reagents, facilities, tedious procedures, and trained personnel. We designed a device for rapid (20-second) noninvasive diagnosis of Plasmodium falciparum infection in a malaria patient without drawing blood or using any reagent. This method uses transdermal optical excitation and acoustic detection of vapor nanobubbles around intraparasite hemozoin. The same device also identified individual malaria parasite–infected Anopheles mosquitoes in a few seconds and can be realized as a low-cost universal tool for clinical and field diagnoses.
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Abstract
PURPOSE OF REVIEW Limitations of blood smear microscopy contributed to failure of the 1950-1960s WHO Global Programme to Eliminate Malaria. All diagnostic methods encounter limits of detection (LOD) beyond which it will not be possible to identify infected individuals. When this occurs, it becomes difficult to continue evaluating progress of malaria elimination. The purpose of this review is to compare available diagnostic technologies, factors that underlie their LOD, and their potential roles related to the goal of elimination. RECENT FINDINGS Parasite-containing cells, parasite proteins, hemozoin, nucleic acids, and parasite-specific human antibodies are targets of diagnosis. Many studies report advantages of technologies to detect these diagnostic targets. Nucleic acid amplification tests and strategies for enriching capture of malaria diagnostic targets have consistently identified a parasite reservoir not detected by methods focused on the other biological targets. Exploiting magnetic properties of hemozoin may open new strategies for noninvasive malaria diagnosis. SUMMARY Microscopy and rapid diagnostic tests provide effective surveillance for malaria control. Strategies that detect a reservoir of submicroscopic infection must be developed and standardized to guide malaria elimination.
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Britton S, Cheng Q, McCarthy JS. Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings. Malar J 2016; 15:88. [PMID: 26879936 PMCID: PMC4754967 DOI: 10.1186/s12936-016-1158-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 02/09/2016] [Indexed: 02/08/2023] Open
Abstract
As malaria transmission continues to decrease, an increasing number of countries will enter pre-elimination and elimination. To interrupt transmission, changes in control strategies are likely to require more accurate identification of all carriers of Plasmodium parasites, both symptomatic and asymptomatic, using diagnostic tools that are highly sensitive, high throughput and with fast turnaround times preferably performed in local health service settings. Currently available immunochromatographic lateral flow rapid diagnostic tests and field microscopy are unlikely to consistently detect infections at parasite densities less than 100 parasites/µL making them insufficiently sensitive for detecting all carriers. Molecular diagnostic platforms, such as PCR and LAMP, are currently available in reference laboratories, but at a cost both financially and in turnaround time. This review describes the recent progress in developing molecular diagnostic tools in terms of their capacity for high throughput and potential for performance in non-reference laboratories for malaria elimination.
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Affiliation(s)
- Sumudu Britton
- University of Queensland, Brisbane, Australia. .,QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Qin Cheng
- Australian Army Malaria Institute, Brisbane, Australia.
| | - James S McCarthy
- University of Queensland, Brisbane, Australia. .,QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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Sánchez-Ovejero C, Benito-Lopez F, Díez P, Casulli A, Siles-Lucas M, Fuentes M, Manzano-Román R. Sensing parasites: Proteomic and advanced bio-detection alternatives. J Proteomics 2016; 136:145-56. [PMID: 26773860 DOI: 10.1016/j.jprot.2015.12.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/22/2015] [Accepted: 12/29/2015] [Indexed: 12/12/2022]
Abstract
Parasitic diseases have a great impact in human and animal health. The gold standard for the diagnosis of the majority of parasitic infections is still conventional microscopy, which presents important limitations in terms of sensitivity and specificity and commonly requires highly trained technicians. More accurate molecular-based diagnostic tools are needed for the implementation of early detection, effective treatments and massive screenings with high-throughput capacities. In this respect, sensitive and affordable devices could greatly impact on sustainable control programmes which exist against parasitic diseases, especially in low income settings. Proteomics and nanotechnology approaches are valuable tools for sensing pathogens and host alteration signatures within microfluidic detection platforms. These new devices might provide novel solutions to fight parasitic diseases. Newly described specific parasite derived products with immune-modulatory properties have been postulated as the best candidates for the early and accurate detection of parasitic infections as well as for the blockage of parasite development. This review provides the most recent methodological and technological advances with great potential for bio-sensing parasites in their hosts, showing the newest opportunities offered by modern "-omics" and platforms for parasite detection and control.
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Affiliation(s)
- Carlos Sánchez-Ovejero
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain
| | - Fernando Benito-Lopez
- Analytical Chemistry Department, Universidad del País Vasco UPV/EHU, 01006 Vitoria-Gasteiz, Spain
| | - Paula Díez
- Department of Medicine and General Cytometry Service-Nucleus, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Adriano Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, - 00161 Rome, Italy
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain
| | - Manuel Fuentes
- Department of Medicine and General Cytometry Service-Nucleus, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain.
| | - Raúl Manzano-Román
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), 37008 Salamanca, Spain.
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Hemozoin Detection for Human Malaria Diagnosis Investigated in Rodent Models: How Similar Is Similar? Trends Parasitol 2015; 32:94-96. [PMID: 26704075 DOI: 10.1016/j.pt.2015.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 01/09/2023]
Abstract
New malaria diagnostic methods based on hemozoin (Hz) detection have been reported recently and were investigated in rodent models. These models are likely to produce unduly favorable results compared to the reality of Plasmodium falciparum malaria. Thus, for malaria diagnostics, results from rodent malaria experiments must be interpreted with caution.
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Rebelo M, Tempera C, Fernandes JF, Grobusch MP, Hänscheid T. Assessing anti-malarial drug effects ex vivo using the haemozoin detection assay. Malar J 2015; 14:140. [PMID: 25879757 PMCID: PMC4393616 DOI: 10.1186/s12936-015-0657-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 03/17/2015] [Indexed: 11/20/2022] Open
Abstract
Background In vitro sensitivity assays are crucial to detect and monitor drug resistance. Plasmodium falciparum has developed resistance to almost all anti-malarial drugs. Although different in vitro drug assays are available, some of their inherent characteristics limit their application, especially in the field. A recently developed approach based on the flow cytometric detection of haemozoin (Hz) allowed reagent-free monitoring of parasite maturation and detection of drug effects in culture-adapted parasites. In this study, the set-up, performance and usefulness of this novel assay were investigated under field conditions in Gabon. Methods An existing flow cytometer (Cyflow Blue) was modified on site to detect light depolarization caused by Hz. Blood from malaria patients was incubated for 72 hrs with increasing concentrations of chloroquine, artesunate and artemisinin. The percentage of depolarizing red blood cells (RBC) was used as maturation indicator and measured at 24, 48 and 72 hrs of incubation to determine parasite growth and drug effects. Results The flow cytometer was easily adapted on site to detect light depolarization caused by Hz. Analysis of ex vivo cultures of parasites, obtained from blood samples of malaria patients, showed four different growth profiles. In 39/46 samples, 50% inhibitory concentrations (IC50) were successfully determined. IC50 values for chloroquine were higher than 200 nM in 70% of the samples, indicating the presence of chloroquine-resistant parasites. For artesunate and artemisinin, IC50 values ranged from 0.9 to 60 nM and from 2.2 nM to 124 nM, respectively, indicating fully sensitive parasites. Conclusion Flow cytometric detection of Hz allowed the detection of drug effects in blood samples from malaria patients, without using additional reagents or complex protocols. Adjustment of the initial parasitaemia was not required, which greatly simplifies the protocol, although it may lead to different IC50 values. Further investigation of set-up conditions of the Hz assay, as well as future studies in various settings should be performed to further determine the usefulness of this assay as a tool for rapid resistance testing in malaria-endemic countries.
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Affiliation(s)
- Maria Rebelo
- Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Av Prof Egas Moniz, Lisbon, P-1649-028, Portugal. .,Centre de Recherches Médicales de Lambaréné - CERMEL, Albert Schweitzer Hospital, Lambaréné, Gabon.
| | - Carolina Tempera
- Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Av Prof Egas Moniz, Lisbon, P-1649-028, Portugal.
| | - José F Fernandes
- Centre de Recherches Médicales de Lambaréné - CERMEL, Albert Schweitzer Hospital, Lambaréné, Gabon. .,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. .,Centre of Tropical Medicine and Travel Medicine, Amsterdam Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné - CERMEL, Albert Schweitzer Hospital, Lambaréné, Gabon. .,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany. .,Centre of Tropical Medicine and Travel Medicine, Amsterdam Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Thomas Hänscheid
- Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Av Prof Egas Moniz, Lisbon, P-1649-028, Portugal. .,Centre de Recherches Médicales de Lambaréné - CERMEL, Albert Schweitzer Hospital, Lambaréné, Gabon. .,Instituto de Microbiologia, Faculdade de Medicina, Lisbon, Portugal.
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Rebelo M, Tempera C, Bispo C, Andrade C, Gardner R, Shapiro HM, Hänscheid T. Light depolarization measurements in malaria: A new job for an old friend. Cytometry A 2015; 87:437-45. [PMID: 25808846 DOI: 10.1002/cyto.a.22659] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/28/2015] [Accepted: 02/27/2015] [Indexed: 12/15/2022]
Abstract
The use of flow cytometry in malaria research has increased over the last decade. Most approaches use nucleic acid stains to detect parasite DNA and RNA and require complex multi-color, multi-parameter analysis to reliably detect infected red blood cells (iRBCs). We recently described a novel and simpler approach to parasite detection based on flow cytometric measurement of scattered light depolarization caused by hemozoin (Hz), a pigment formed by parasite digestion of hemoglobin in iRBCs. Depolarization measurement by flow cytometry was described in 1987; however, patent issues restricted its use to a single manufacturer's hematology analyzers until 2009. Although we recently demonstrated that depolarization measurement of Hz, easily implemented on a bench top flow cytometer (Cyflow), provided useful information for malaria work, doubts regarding its application and utility remain in both the flow cytometry and malaria communities, at least in part because instrument manufacturers do not offer the option of measuring depolarized scatter. Under such circumstances, providing other researchers with guidance as to how to do this seemed to offer the most expeditious way to resolve the issue. We accordingly examined how several commercially available flow cytometers (CyFlow SL, MoFLo, Attune and Accuri C6) could be modified to detect depolarization due to the presence of free Hz on solution, or of Hz in leukocytes or erythrocytes from rodent or human blood. All were readily adapted, with substantially equivalent results obtained with lasers emitting over a wide wavelength range. Other instruments now available may also be modifiable for Hz measurement. Cytometric detection of Hz using depolarization is useful to study different aspects of malaria. Adding additional parameters, such as DNA content and base composition and RNA content, can demonstrably provide improved accuracy and sensitivity of parasite detection and characterization, allowing malaria researchers and eventually clinicians to benefit from cytometric technology.
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Affiliation(s)
- Maria Rebelo
- Molecular Microbiology and Infection Unit, Instituto De Medicina Molecular, Faculdade De Medicina, Lisbon, Portugal
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Fransisca L, Kusnanto JH, Satoto TBT, Sebayang B, Supriyanto, Andriyan E, Bangs MJ. Comparison of rapid diagnostic test Plasmotec Malaria-3, microscopy, and quantitative real-time PCR for diagnoses of Plasmodium falciparum and Plasmodium vivax infections in Mimika Regency, Papua, Indonesia. Malar J 2015; 14:103. [PMID: 25890368 PMCID: PMC4356117 DOI: 10.1186/s12936-015-0615-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization recommends malaria be diagnosed by standard microscopy or rapid diagnostic test (RDT) before treatment. RDTs have been used with greater frequency in the absence of matching blood slide confirmation in the majority of RDT reported cases in Mimika Regency, Papua Province, Indonesia. Given the importance of RDT in current health system as point-of-care tool, careful validation of RDT product performance for providing accurate malaria diagnosis is critical. METHODS Plasmotec Malaria-3 (XW-P07) performance was evaluated by comparing it with paired blood film microscopy and quantitative real-time PCR (qPCR). Consecutive whole blood samples were derived from one clinic in Mimika as part of routine passive malaria case detection. RDT results were read by two trained technicians and interpreted by consensus. Expert microscopic examination of blood slides was cross-checked by observer-blinded second reader and a third examiner if discordant between examinations. qPCR was used as the 'gold standard', followed by microscopy for the outcome/disease variable. Comparison analysis included sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV & NPV), and other diagnostic screening performance measures for detecting Plasmodium falciparum and Plasmodium vivax infections. RESULTS Overall malaria positive samples from qPCR was 42.2% (175/415 samples); and from matching blood slides 40.5% (168/415) of which those infections with relatively low parasite densities ≤100/μl blood was 5.7% of P. falciparum and 16.5% of P. vivax samples examined. Overall RDT performance when compared with microscopy for detecting P. falciparum was Sn:92%, Sp:96.6%, PPV:88%, NPV:97.8%, Kappa:0.87; and for P. vivax Sn:72.9%, Sp:99.1%, PPV:95.4%, NPV:93.4%, Kappa:0.79. Overall RDT performance when compared with qPCR for detecting P. falciparum was Sn:92%, Sp:96.6%, PPV:88%, NPV:97.8%, Kappa:0.87; and for P. vivax Sn:66%, Sp:99.1%, PPV:95.4%, NPV:90.9%, Kappa:0.73. CONCLUSIONS Plasmotec Malaria-3 test showed good overall performance scores in precision for detecting P. falciparum, but lower values regarding sensitivity and negative likelihood ratio for detecting P. vivax, a finding partly associated with greater frequency of lower density P. vivax infections compared to P. falciparum in this study. In particular, the negative likelihood ratio (>0.1) for P. vivax detection indicates RDT lacked sufficient discriminating exclusion power falling below general acceptance criteria.
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Affiliation(s)
- Liony Fransisca
- Public Health & Malaria Control, International SOS, PT. Freeport Indonesia, Kuala Kencana, Papua, Indonesia.
| | - Josef Hari Kusnanto
- Center for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | - Tri Baskoro T Satoto
- Public Health Department, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
| | - Boni Sebayang
- Public Health & Malaria Control, International SOS, PT. Freeport Indonesia, Kuala Kencana, Papua, Indonesia.
| | - Supriyanto
- Public Health & Malaria Control, International SOS, PT. Freeport Indonesia, Kuala Kencana, Papua, Indonesia.
| | - Eko Andriyan
- Public Health & Malaria Control, International SOS, PT. Freeport Indonesia, Kuala Kencana, Papua, Indonesia.
| | - Michael J Bangs
- Public Health & Malaria Control, International SOS, PT. Freeport Indonesia, Kuala Kencana, Papua, Indonesia.
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