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DETECTION OF PLASMODIUM FALCIPARUM IN PREGNANCY BY LASER DESORPTION MASS SPECTROMETRY

Detection of Plasmodium falciparum malaria during pregnancy is complicated by sequestration of parasites in the placenta, which reduces peripheral blood microscopic detection. Laser desorption mass spectrometry (LDMS) has previously demonstrated sensitive detection of hemozoin from P. falciparum blood cultures and the ability to track parasitemia in a Plasmodium yoelii malaria mouse model. Here we use a simple, dilution in water, blood sample preparation protocol for LDMS detection of malaria in 45 asymptomatic, pregnant Zambian women. We compare LDMS to microscopy and polymerase chain reaction (PCR) analysis. All women were microscopy negative. LDMS detected P. falciparum hemozoin in 15 out of 45 women, while PCR results were positive in 25 women. Compared with PCR, which analyzed 20–30 µL of blood, the sensitivity of LDMS, which analyzed < 1 µL of blood, was 52%, with a specificity of 92%. LDMS is a potentially rapid and more sensitive alternate diagnostic method than microscopy.

Received January 25, 2005. Accepted for publication April 6, 2005.

Financial support: Myaing Nyunt was supported by a Pfizer Centennial Travel Award in Basic Science Parasitology through the American Society of Tropical Medicine and Hygiene. D. Sullivan was supported by grant NIH RO1 A145774 and a PEW Scholars Award in Biomedical Sciences. NCCR grant GPDGCRC RR0052 supported the culturing of P. falciparum for the production of control hemozoin samples. Additional support was provided by the Johns Hopkins Malaria Research Institute.

^* Address correspondence to David J. Sullivan, Jr., Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205-2179. E-mail: dsulliva{at}jhsph.edu

Authors’ addresses: Myaing Nyunt, Division of Clinical Pharmacology, Johns Hopkins University, 725 N. Wolfe St., Baltimore, MD 21205. John Pisciotta, Lirong Shi, Nirbhay Kumar, and David J. Sullivan, Jr., Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205-2179. Philip Thuma, MIAM, P.O. Box 630166, Choma, Zambia. Andrew B. Feldman, Plamen A. Demirev, and Jeffrey S. Lin, M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Rd., Laurel, MD 20723-6099. Peter F. Scholl, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205-2179.

Reprint requests: David J. Sullivan, Jr., Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205-2179, Telephone: 410-502-2522, Fax: 410-955-0105, E-mail: dsulliva{at}jhsph.edu.

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