A portable image-based cytometer for rapid malaria detection and quantification.
A portable image-based cytometer for rapid malaria detection and quantification.
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DOI：
10.1371/journal.pone.0179161
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Ai Y
中科院分区：
文献类型：
--
作者：
Yang D;Subramanian G;Duan J;Gao S;Bai L;Chandramohanadas R;Ai Y
发展中国家疟原虫对目前使用的抗疟药的耐药性不断增加，需要及时检测和分类，以便在临床并发症出现之前施用适当的药物组合。然而，这常常受到低水平感染（称为寄生虫血症）和患者外周血中主要存在年轻寄生虫形式的挑战。在此，我们开发了一种简单、廉价且便携式的基于图像的细胞仪，可从感染血液的吉姆萨染色涂片中检测并计数恶性疟原虫感染的红细胞（iRBC）。我们的细胞仪能够通过量化 iRBC 内寄生虫占据的面积来对所有寄生虫亚群进行分类，具有高特异性、敏感性和可忽略不计的假阳性 (~ 0.0025%)。此外，我们展示了基于图像的细胞仪在测试商业流式细胞仪的抗疟功效中的应用，并证明了两种方法之间的可比结果。总的来说，这些结果凸显了使用我们的基于图像的细胞仪作为抗疟测试的廉价、快速和准确的替代方案的可能性，而不会影响效率和最短的处理时间。通过在算法中应用适当的过滤器，以排除白细胞和网织红细胞，我们的细胞仪还可用于疟疾的现场诊断。
Increasing resistance by malaria parasites to currently used antimalarials across the developing world warrants timely detection and classification so that appropriate drug combinations can be administered before clinical complications arise. However, this is often challenged by low levels of infection (referred to as parasitemia) and presence of predominantly young parasitic forms in the patients’ peripheral blood. Herein, we developed a simple, inexpensive and portable image-based cytometer that detects and numerically counts Plasmodium falciparum infected red blood cells (iRBCs) from Giemsa-stained smears derived from infected blood. Our cytometer is able to classify all parasitic subpopulations by quantifying the area occupied by the parasites within iRBCs, with high specificity, sensitivity and negligible false positives (~ 0.0025%). Moreover, we demonstrate the application of our image-based cytometer in testing anti-malarial efficacy against a commercial flow cytometer and demonstrate comparable results between the two methods. Collectively, these results highlight the possibility to use our image-based cytometer as a cheap, rapid and accurate alternative for antimalarial testing without compromising on efficiency and minimal processing time. With appropriate filters applied into the algorithm, to rule out leukocytes and reticulocytes, our cytometer may also be used for field diagnosis of malaria.