title: Cytometry in malaria--a practical replacement for microscopy?
abstract: Malaria, caused by protozoan Plasmodium parasites, kills ~800,000 people each year. Exact figures are uncertain because presumptive diagnoses are often made without identifying parasites in patients' blood either by microscopy, using Giemsa's century-old stain, or by simpler tests that are ultimately dependent on microscopy for quality control. Microscopy itself relies on trained observers' ability to detect subtle morphological features of parasitized red blood cells, only a few of which may be present on a slide. Quantitative and objective flow cytometric measurements of cellular constituents such as DNA, RNA, and the malaria pigment hemozoin are now useful in research in malaria biology and pharmacology, and can provide more reliable identification of parasite species and developmental stages and better detection of low-density parasitemia than could microscopy. The same measurements can now be implemented in much smaller, simpler, cheaper imaging cytometers, potentially providing a more accurate and precise diagnostic modality.
authors.affiliation: The Center for Microbial Cytometry, West Newton, Massachusetts.
authors.forename: Howard M
authors.initials: HM
authors.lastname: Shapiro
authors.affiliation: Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
authors.forename: Simon H
authors.initials: SH
authors.lastname: Apte
authors.affiliation: Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Chojnowski
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hänscheid
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
authors.forename: Maria
authors.initials: M
authors.lastname: Rebelo
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Grimberg
mesh_terms: D000818:Animals; D001399:Azure Stains; D035843:Biomedical Research; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D008853:Microscopy / Q000379:methods*; D010271:Parasites / Q000502:physiology
chemical_list: D001399:Azure Stains