DETECTION OF PLASMODIUM FALCIPARUM IN PREGNANCY BY LASER DESORPTION MASS SPECTROMETRY

MYAING NYUNT Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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JOHN PISCIOTTA Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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ANDREW B. FELDMAN Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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PHILIP THUMA Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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PETER F. SCHOLL Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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PLAMEN A. DEMIREV Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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JEFFREY S. LIN Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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LIRONG SHI Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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NIRBHAY KUMAR Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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DAVID J. SULLIVAN JR. Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Malaria Institute at Macha, Choma, Zambia; M. S. Eisenhower Research and Technology Development Center, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

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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.

Author Notes

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@jhsph.edu.
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