Zimmerman Peter A, Thomson Jodi M, Fujioka Hisashi, Collins William E, Zborowski Maciej
Case Western Reserve University, Center for Global Health and Diseases, Cleveland, Ohio 44106-7286, USA.
Am J Trop Med Hyg. 2006 Apr;74(4):568-72.
Although malaria contributes to a significant public health burden, malaria diagnosis relies heavily on either non-specific clinical symptoms or blood smear microscopy methods developed in the 1930s. These approaches severely misrepresent the number of infected individuals and the reservoir of parasites in malaria-endemic communities and undermine efforts to control disease. Limitations of conventional microscopy-based diagnosis center on time required to examine slides, time required to attain expertise sufficient to diagnose infection accurately, and attrition from the limited number of existing malaria microscopy experts. Earlier studies described magnetic properties of Plasmodium falciparum but did not refine methods to diagnosis infection by all four human malaria parasite species. Here, following specific technical procedures, we show that it is possible to concentrate all four human malaria parasite species, at least 40-fold, on microscope slides using very inexpensive magnets through an approach termed magnetic deposition microscopy. This approach delivered greater sensitivity than a thick smear preparation while maintaining the clarity of a thin smear to simplify species-specific diagnosis. Because the magnetic force necessary to concentrate parasites on the slide is focused at a precise position relative to the magnet surface, it is possible to examine a specific region of the slide for parasitized cells and avoid the time-consuming process of scanning the entire slide surface. These results provide insight regarding new strategies for performing malaria blood smear microscopy.
尽管疟疾造成了巨大的公共卫生负担,但疟疾诊断严重依赖于非特异性临床症状或20世纪30年代开发的血涂片显微镜检查方法。这些方法严重误报了疟疾流行社区中受感染个体的数量和寄生虫库,并破坏了疾病控制工作。基于传统显微镜的诊断的局限性集中在检查载玻片所需的时间、获得足以准确诊断感染的专业知识所需的时间,以及现有疟疾显微镜专家数量有限导致的人员流失。早期研究描述了恶性疟原虫的磁性,但没有完善诊断所有四种人类疟原虫感染的方法。在此,按照特定的技术程序,我们表明,通过一种称为磁沉积显微镜的方法,使用非常便宜的磁铁,可以在显微镜载玻片上至少将所有四种人类疟原虫浓缩40倍。这种方法比厚涂片制备具有更高的灵敏度,同时保持了薄涂片的清晰度,以简化物种特异性诊断。由于将寄生虫浓缩在载玻片上所需的磁力集中在相对于磁铁表面的精确位置,因此可以检查载玻片的特定区域以寻找被寄生的细胞,避免扫描整个载玻片表面这一耗时的过程。这些结果为进行疟疾血涂片显微镜检查的新策略提供了见解。