title: Detection of Plasmodium falciparum in pregnancy by laser desorption mass spectrometry.
abstract: 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 microL of blood, the sensitivity of LDMS, which analyzed < 1 microL of blood, was 52%, with a specificity of 92%. LDMS is a potentially rapid and more sensitive alternate diagnostic method than microscopy.
authors.affiliation: Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
authors.forename: Myaing
authors.initials: M
authors.lastname: Nyunt
authors.forename: John
authors.initials: J
authors.lastname: Pisciotta
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Feldman
authors.forename: Philip
authors.initials: P
authors.lastname: Thuma
authors.forename: Peter F
authors.initials: PF
authors.lastname: Scholl
authors.forename: Plamen A
authors.initials: PA
authors.lastname: Demirev
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Lin
authors.forename: Lirong
authors.initials: L
authors.lastname: Shi
authors.forename: Nirbhay
authors.initials: N
authors.lastname: Kumar
authors.forename: David J
authors.initials: DJ
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology; D002738:Chloroquine / Q000494:pharmacology; D004338:Drug Combinations; D004351:Drug Resistance / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy; D010963:Plasmodium falciparum / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D011739:Pyrimethamine / Q000494:pharmacology; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013413:Sulfadoxine / Q000494:pharmacology
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine