Magneto-optical diagnosis of symptomatic malaria in Papua New Guinea

Arndt, Leandra; Koleala, Tamarah; Orbán, Ágnes; Ibam, Clemencia; Lufele, Elvin; Timinao, Lincoln; Lorry, Lina; Butykai, Ádám; Kaman, Peter; Molnár, A.P.; Krohns, S.; Nate, Elma; Kucsera, István; Orosz, Erika; Moore, Brioni R.; Robinson, Leanne J.; Laman, Moses; Kézsmárki, I.; Karl, Stephan

doi:10.1038/s41467-021-21110-w

Cited by 29 publications

(34 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, detection can occur since the early stages of infection and is maintained across different stages of the parasite lifecycle [25]. Furthermore, there is increasing clinical evidence that show that magneto-optical detection can be useful in P. vivax predominant elimination settings [26].…”

Section: Introductionmentioning

confidence: 99%

Field validation of a magneto-optical detection device (Gazelle) for portable point-of-care Plasmodium vivax diagnosis

Valdivia

Thota²,

Braga

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

Field validation of a magneto-optical detection device (Gazelle) for portable point-of-care Plasmodium vivax diagnosis

Valdivia

Thota²,

Braga

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…For comparison, this sensitivity threshold is somewhat better than the threshold reported in the recent field test of the Gazelle device, where the parasite density of false negative cases was reported to range from 18 to 174 µl −1 , when optical microscopy was used as a reference [20]. [15]. The blue dashed line marks the cut-off value for RMOD determined by receiver operating characteristic (ROC) analysis in that study [15].…”

Section: Resultsmentioning

confidence: 76%

“…The black continuous and dashed lines indicate the mean MO value of the malaria-naïve samples and the cut-off level, respectively, while the black arrow marks the estimated lowest detectable parasite density by RMOD. Panel C.The blue asterisks show the MO values of P. vivax-infected samples collected in Papua New Guinea (n=104), as reproduced from Ref [15]…”

mentioning

confidence: 99%

Sensitive detection of Plasmodium vivax malaria by the rotating-crystal magneto-optical method in Thailand

Orbán

Longley

Sripoorote

et al. 2021

Preprint

View full text Add to dashboard Cite

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 ~ 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.

show abstract

“…NMR has historically been expensive, but there are moves to make the technology smaller and cheaper [ 159 ]. Rotating-crystal magneto-optical detection (RMOD) utilizes the different magnetic properties of malaria infected blood because the Plasmodium infection results in hemoglobin breakdown that liberates the iron-containing organic crystal called hemozoin [ 160 ]. RMOD has shown great promise, including very good levels of detection of P. vivax (87% sensitivity and 88% specificity), which could be incorporated into a comprehensive malaria strategy in non-falciparum regions where RDT assays have lower sensitivity.…”

Section: Emerging Diagnostic Technologiesmentioning

confidence: 99%

Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm

2021

View full text Add to dashboard Cite

Malaria rapid diagnostic tests (RDTs) have had an enormous global impact which contributed to the World Health Organization paradigm shift from empiric treatment to obtaining a parasitological diagnosis prior to treatment. Microscopy, the classic standard, requires significant expertise, equipment, electricity, and reagents. Alternatively, RDT’s lower complexity allows utilization in austere environments while achieving similar sensitivities and specificities. Worldwide, there are over 200 different RDT brands that utilize three antigens: Plasmodium histidine-rich protein 2 (PfHRP-2), Plasmodium lactate dehydrogenase (pLDH), and Plasmodium aldolase (pALDO). pfHRP-2 is produced exclusively by Plasmodium falciparum and is very Pf sensitive, but an alternative antigen or antigen combination is required for regions like Asia with significant Plasmodium vivax prevalence. RDT sensitivity also decreases with low parasitemia (<100 parasites/uL), genetic variability, and prozone effect. Thus, proper RDT selection and understanding of test limitations are essential. The Center for Disease Control recommends confirming RDT results by microscopy, but this is challenging, due to the utilization of clinical laboratory standards, like the College of American Pathologists (CAP) and the Clinical Lab Improvement Act (CLIA), and limited recourses. Our focus is to provide quality assurance and quality control strategies for resource-constrained environments and provide education on RDT limitations.

show abstract

Magneto-optical diagnosis of symptomatic malaria in Papua New Guinea

Cited by 29 publications

References 68 publications

Field validation of a magneto-optical detection device (Gazelle) for portable point-of-care Plasmodium vivax diagnosis

Field validation of a magneto-optical detection device (Gazelle) for portable point-of-care Plasmodium vivax diagnosis

Sensitive detection of Plasmodium vivax malaria by the rotating-crystal magneto-optical method in Thailand

Malaria Rapid Diagnostic Tests: Literary Review and Recommendation for a Quality Assurance, Quality Control Algorithm

Contact Info

Product

Resources

About