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Journal of Clinical Microbiology, September 1999, p. 2992-2996, Vol. 37, No. 9
Faculty of Medicine and Biomedical Sciences,
The Biotechnology Center, University of Yaounde 1, Yaounde,
Cameroon,1 and Department of Biology,
Georgetown University, Washington, D.C. 200572
Received 9 February 1999/Returned for modification 7 April
1999/Accepted 7 June 1999
Pregnant women have an increased susceptibility to infection by
Plasmodium falciparum. Parasites may be present in the
placenta yet not detectable in peripheral blood smears by routine light microscopy. In order to determine how frequently misdiagnosis occurs,
peripheral blood and placental samples were collected from 1,077 Cameroonian women at the time of giving birth and examined for the
presence of malarial parasites by using light microscopy. Results
showed that 20.1% of the women who had placental malaria were
peripheral blood smear negative. Thus, malarial infection was not
detected by microscopic examination of peripheral blood smears from
approximately one out of five malaria-infected women. Since P. falciparum parasites secrete histidine-rich protein 2 (HRP-2), we
sought to determine if detecting HRP-2 in either peripheral plasma or
whole blood might be used to diagnose the presence of parasites
"hidden" in the placenta. Samples of peripheral plasma from 127 women with different levels of placental malarial infection were
assayed by HRP-2-specific enzyme-linked immunosorbent assay. HRP-2 was
detected in 88% of the women with placental malaria who tested
negative by blood smear. Additionally, whole blood was obtained from
181 women and tested for HRP-2 with a rapid, chromatographic strip test
(ICT). The ICT test accurately detected malarial infection in 89.1% of
P. falciparum-infected women. Furthermore, 94% of women
with malaria were accurately diagnosed by using a combination of
microscopy and the ICT test. Thus, detection of HRP-2 in conjunction
with microscopy should improve diagnosis of malaria in pregnant women.
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Detection of the Plasmodium falciparum
Antigen Histidine-Rich Protein 2 in Blood of Pregnant Women:
Implications for Diagnosing Placental Malaria
*
Corresponding author. Mailing address: Department of
Biology, Reiss Science Center, Rm. 334, Georgetown University, 37th and O St., NW, Washington, DC 20057. Phone: (202) 687-5972. Fax: (202) 687-5662. E-mail: taylordw{at}gusun.georgetown.edu.
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