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DIAGNOSIS OF MALARIA BY MAGNETIC DEPOSITION MICROSCOPY

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.

Received August 3, 2005. Accepted for publication January 11, 2006.

Acknowledgments: The authors thank Boris Kligman, JoAnn Sullivan, and Kiet Luc for technical assistance and David McNamara and Laurin Kasehagen for helpful comments and criticisms during the preparation of the manuscript.

Financial support: This work was supported by NIH AI46919, AI52312 (P. A. Zimmerman), and CA62349 (M. Zborowski.). J. M. Thomson was supported in part by NIH T32 GM07250 and the Case Medical Scientist Training Program.

^* Address correspondence to Peter A. Zimmerman, Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Wolstein Research Building, 4-125, Cleveland, OH 44106-7286. E-mail: paz{at}case.edu

Authors’ addresses: Peter A. Zimmerman and Jodi M. Thomson, Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Wolstein Research Building, 4-125, Cleveland, OH 44106-7286. Hisashi Fujioka, Institute of Pathology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, OH 44106-4907. William E. Collins, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Chamblee, GA 30341. Maciej Zborowski, Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.

Reprint requests: Peter A. Zimmerman, Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Wolstein Research Building, 4-125, Cleveland, OH 44106-7286. E-mail: paz{at}case.edu.