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Journal of Clinical Microbiology, September 1999, p. 2992-2996, Vol. 37, No. 9
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

Rose F. G. Leke,1 Rosine R. Djokam,1 Robinson Mbu,1 Robert J. Leke,1 Josephine Fogako,1 Rosette Megnekou,1 Simon Metenou,1 Grace Sama,1 Yuan Zhou,2 Timothy Cadigan,2 Marcela Parra,2 and Diane Wallace Taylor2,*

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.

* 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.

Journal of Clinical Microbiology, September 1999, p. 2992-2996, Vol. 37, No. 9
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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