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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ParaSight(R)-F test is a qualitative diagnostic test of Plasmodium falciparum, which is based on the detection by a monoclonal antibody of a species-specific soluble antigen (histidine-rich protein (HRP-II)) in whole blood and which can be performed without special equipment. A visual reading is given by a polyclonal antibody coupled with dye-loaded liposomes; when positive, a pink line appears. The test has been compared with microscopic examination of thin blood smears and with Quantitative Buffy Coat malaria test (QBC(R) in a single-blind study. A total of 358 patients who had returned to France from malarial areas and consulted their doctor with symptoms or for a routine examination were enrolled in the study; 33 of them were found to have a falciparum malaria infection by the diagnostic test. On the day of consultation, the specificity of the ParaSight(R)-F test was 99% and its sensitivity 94%. The follow-up of infected patients after treatment showed that the test became negative later than the other reference tests. There was no correlation between antigen persistence and the intensity of the ParaSight(R)-F signal or circulating parasitaemia. No cross-reaction was noted for seven malaria cases due to other Plasmodium species. The test was performed quickly (10 tests in 20 minutes), was easy to read, and required minimal space. For cases of imported malaria, the test's specificity and low threshold for detection could make it a valuable adjunct test. However, in its present form, it cannot replace microscopic techniques which are species-specific and quantitative. In endemic areas, the test seems to be very promising by its results and ease of use according to published field studies.
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PMID:ParaSight-F rapid manual diagnostic test of Plasmodium falciparum infection. 884 90

A field trial comparing a dipstick test, an antigen-capture test detecting trophozoite-derived histidine-rich protein-II, and the quantitative buffer coat (QBC) (acridine orange staining technique) assay for the detection of Plasmodium falciparum was carried out on a population of 1,398 suspected malaria patients in gold mining areas of Venezuela. Sensitivity, specificity, and positive predictive values were higher for the dipstick test than for the acridine orange staining compared with the thick blood smear. The sensitivity for the dipstick method was 86.7% (95% confidence interval [CI] = 82-90%), the specificity was 99.3% (95% CI = 98.5-99.7%), and the positive predictive value was 97.1% (95% CI = 94-98%) as compared with the thick blood smear. The sensitivity for acridine orange staining was 82.2% (95% CI = 77-86%), the specificity was 98.5% (95% CI = 97.6-99.1%), and the positive predictive value was 94.1% (95% CI = 90-97%); with a P. falciparum asexual parasitemia higher than 21 parasites/microliter, the dipstick was 100% sensitive, when parasitemia was 10-20/microliter, sensitivity was 88%, and when parasitemia was less than 10/microliter, it was only 13.4%. The dipstick assay meets the criteria for an appropriate, rapid, and reliable test for the diagnosis of P. falciparum and has advantages over the acridine orange staining method. Nonetheless, its effectiveness seems limited in areas with low prevalence and among patients with low levels of parasitemia.
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PMID:The evaluation of a dipstick test for Plasmodium falciparum in mining areas of Venezuela. 894 Sep 77

Accurate localization of proteins within the substructure of cells and cellular organelles enables better understanding of structure-function relationships, including elucidation of protein-protein interactions. We describe the use of a near-field scanning optical microscope (NSOM) to simultaneously map and detect colocalized proteins within a cell, with superresolution. The system we elected to study was that of human red blood cells invaded by the human malaria parasite Plasmodium falciparum. During intraerythrocytic growth, the parasite expresses proteins that are transported to the erythrocyte cell membrane. Association of parasite proteins with host skeletal proteins leads to modification of the erythrocyte membrane. We report on colocalization studies of parasite proteins with an erythrocyte skeletal protein. Host and parasite proteins were selectively labeled in indirect immunofluorescence antibody assays. Simultaneous dual-color excitation and detection with NSOM provided fluorescence maps together with topography of the cell membrane with subwavelength (100 nm) resolution. Colocalization studies with laser scanning confocal microscopy provided lower resolution (310 nm) fluorescence maps of cross sections through the cell. Because the two excitation colors shared the exact same near-field aperture, the two fluorescence images were acquired in perfect, pixel-by-pixel registry, free from chromatic aberrations, which contaminate laser scanning confocal microscopy measurements. Colocalization studies of the protein pairs of mature parasite-infected erythrocyte surface antigen (MESA) (parasite)/protein4.1(host) and P. falciparum histidine rich protein (PfHRP1) (parasite)/protein4.1(host) showed good real-space correlation for the MESA/protein4.1 pair, but relatively poor correlation for the PfHRP1/protein4.1 pair. These data imply that NSOM provides high resolution information on in situ interactions between proteins in biological membranes. This method of detecting colocalization of proteins in cellular structures may have general applicability in many areas of current biological research.
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PMID:Membrane specific mapping and colocalization of malarial and host skeletal proteins in the Plasmodium falciparum infected erythrocyte by dual-color near-field scanning optical microscopy. 901 16

Imported malaria is an increasing problem worldwide. A rapid and accurate test for Plasmodium falciparum infection would facilitate the diagnosis of malaria in the returned traveler. The ParaSight F antigen capture assay (dipstick test) is a new diagnostic test for P. falciparum based on detection of circulating histidine-rich protein-2 antigen. We performed a blinded evaluation of this assay compared with microscopy and the polymerase chain reaction (PCR) for the detection of P. falciparum infection in 151 febrile travelers. Compared with the PCR, the dipstick test had a sensitivity of 88% and a specificity of 97%. The ability of the dipstick test to detect P. falciparum was similar with that of microscopy (88% versus 83%) since the species of Plasmodium in 14 of 133 malaria-infected patients could not be determined by microscopy due to low parasite numbers. The dipstick test was 40% sensitive for infections with < 50 parasites/microliter, 89% with 50-100 parasites/microliter, and > or = 93% with > 100 parasites/microliter. Circulating antigen was detectable in 68% of the patients seven days after initiation of treatment and in 27% at day 28. The dipstick test represents a simple and accurate test for the diagnosis of P. falciparum infection in the returned traveler.
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PMID:Parasight F test compared with the polymerase chain reaction and microscopy for the diagnosis of Plasmodium falciparum malaria in travelers. 906 60

Plasmodium falciparum malaria, the most lethal form of human malaria, claims at least 2 million lives worldwide each year. Recently, there has been a significant advance in our understanding of the molecular basis of P. falciparum sequestration, a distinctive pathologic feature that often leads to fatal human cerebral malaria. Parasite-derived VAR proteins (Plasmodium falciparum-infected erythrocyte membrane protein 1) have been cloned and identified as antigenically diverse cytoadherent receptors localized to the knob protrusions that act as attachment points in parasite sequestration. Evidence now supports the hypothesis that cryptic regions of band 3 protein are parasite-induced, host-derived erythrocyte receptors mediating parasite sequestration. Knob structures have been localized to spectrin-actin-protein 4.1 junctions in intact spread membrane skeletons. A recombinant domain of knob-associated histidine-rich protein, a major protein found in both membrane-intact and isolated knobs, has been shown to associate with filamentous actin and spectrin. Parasite- and host-derived erythrocyte membrane proteins involved in P. falciparum sequestration are discussed in this review.
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PMID:Erythrocyte membrane alterations in Plasmodium falciparum malaria sequestration. 910 33

Plasmodium falciparum histidine rich protein-2 (PfHRP-2) based immunochromatographic test kit (ICT Malaria Pf) for the rapid diagnosis of P. falciparum malaria was evaluated at the clinic of Malaria Research Centre (Field Station), Goa. Of the 98 febrile patients screened, 22 were ICT positive for P. falciparum. Simultaneous microscopic examination of the blood smears of these ICT positive patients showed that 20 were positive for P. falciparum alone, whereas one had mix infection of both P. vivax and P. falciparum suggesting 100% sensitivity. Only one slide negative patient who had taken 600 mg chloroquine the previous day was positive in the ICT. Out of the remaining 76 blood smears, 41 showed P. vivax infection and none cross-reacted with P. falciparum HRP-2 antigen and were ICT negative except one mix infection case in which P. vivax and P. falciparum infections occurred concomitantly suggesting species specificity of 98.7%. The positive predictive value, negative predictive value and efficacy of the ICT were 95.4, 100 and 98.9% respectively. The band intensity of the ICT positive cases significantly correlated with P. falciparum parasitaemia (p < 0.01). The usefulness and the disadvantages of this diagnostic kit have been discussed in context of prevailing malaria situation in the country.
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PMID:Clinical trials of a new immunochromatographic test for diagnosis of Plasmodium falciparum malaria in Goa. 912 30

The knob-associated histidine rich protein (KAHRP) of Plasmodium falciparum plays an important role in the pathophysiology of cerebral malaria. In the present study, the immunogenic C-terminal repeat domain of the KAHRP gene was amplified, cloned and sequenced from the Indian (RJ181) and Honduran (HB3) isolates of P. falciparum. Based on the number and types of repeats in the domain, we report here the presence of three unique variant forms of KAHRP among these isolates. The Indian isolate (RJ181) contained four units of the decapeptide repeats whereas the Honduran isolate (HB3) contained two forms i.e. one form containing four decapeptide repeats plus a tetrapeptide subunit and the other form containing three decapeptide repeats plus a tetrapeptide subunit. Thus, all together, the number of KAHRP variants is increased to five which includes previously described two variants, each containing either 3 or 5 decapeptide repeats. This high rate of variability in the antigenic domain of the KAHRP gene via deletion or addition of whole or part of the decapeptide units could be involved in the evasion of host immune system possibly by providing the speculative complementarity to the vargene product. The results of the present study will be useful in designing the suitable molecular therapeutic reagents for cerebral malaria.
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PMID:Variations in the C-terminal repeats of the knob-associated histidine-rich protein of Plasmodium falciparum. 912 77

The post-treatment diagnostic performance of the Plasmodium falciparum histidine-rich protein (HRP-II) antigen detection test, ParaSight-F test, was assessed on 55 falciparum malaria cases treated with chloroquine during in vivo drug sensitivity studies. The post-treatment sensitivity of the test remained high, except for an insignificant decline on day 1. However, specificity dropped sharply by day 1, subsequently increasing linearly with time to satisfactory values by day 10. As expected, from its inverse relationship to specificity, the false positive rate was high on day 1 and decreased linearly to low level by day 10. The temporary increase in false positive rate-following treatment was due to persistent parasite antigen, rather than subpatent parasitaemia. Thus findings showed that positive readings by the test within 10 days post-treatment may occur in cured cases and will not necessarily imply treatment failure. Furthermore it will be important to take patient antimalarial history into consideration during routine usage of the test for malaria diagnosis. The trend of Youden's J-index for the ParaSight-F test showed that from 10 days post-treatment, the test was generally reliable, with positive readings indicating active infection. It was concluded that the ParaSight-F test was not only valuable at confirming malaria diagnosis on clinical cases in seasonal transmission areas, but had potential for application to detect recrudescent infections within 2 weeks of chloroquine treatment.
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PMID:Post treatment sensitivity studies with the ParaSight-F test for malaria diagnosis in Zimbabwe. 922 98

Rapid diagnosis of Plasmodium falciparum malaria remains one of the main limitations to prompt treatment. Diagnosis based on clinical symptoms is decidedly unreliable, especially in areas of seasonal transmission like Zimbabwe. In view of this, the Plasmodium falciparum histidine rich protein (HRP-II) antigen detection assay (ParaSight-F test) was tried at 10 health centres in 3 malaria endemicity zones of Zimbabwe, as a malaria diagnostic tool for primary health care. Parasitological evaluations were conducted using thick and thin film microscopy as gold standard, and ease of test operation and practicability to nurses were ascertained by questionnaire. The sensitivity of the test did not vary substantially by endemicity zone and was approximately 93%. Specificities were 85, 72 and 92% in the hyperendemic, mesoendemic and hypoendemic zones, respectively. Positive predictive values varied considerably with endemicity, the lowest being in the hypoendemic zone (56%). However, negative predictive values did not change significantly, with a mean of 94%. It was found that the ParaSight-F test reduced mistreatment for malaria, relative to clinical diagnosis, by up to 81%, especially in the hypoendemic region. Test acceptability evaluations were good.
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PMID:Trial of the ParaSight-F test for malaria diagnosis in the primary health care system, Zimbabwe. 923 21

Knob proteins play a significant role in the pathophysiology of cerebral malaria caused by Plasmodium falciparum. Most of these proteins are of parasite origin and can be divided into two major classes: (i) the cytoadherent proteins present at the surface of the knobs; and (ii) the submembranous structural proteins which are placed towards the cytoplasmic side in the knobs. Several surface proteins [viz., P. falciparum-infected erythrocyte membrane protein-1 (PFEMP-1), sequestrin, pfalhesin] and submembranous structural proteins [viz., knob-associated histidine-rich protein (KAHRP), PFEMP-2, PFEMP-3] of the knobs have been identified and characterized to a certain extent. The structural proteins interact with several host (e.g., spectrin, actin, band 4.1 etc.) as well as parasite (e.g., PFEMP-1) molecules to produce functional knobs. The surface proteins on the other hand interact with several adhesion molecules of the endothelial cell through receptor-ligand type of binding. Knob proteins are important from the point of view of malaria control since immunotherapeutic agents can be developed to block as well as reverse the cytoadherence phenomenon. The surface proteins are also good vaccine candidates except that they show a high rate of antigenic variation. Nevertheless, the use of ribozyme or antisense oligonucleotides to inhibit the expression of knob proteins (e.g., KAHRP alone or with surface protein) can be used as a molecular therapeutic agent.
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PMID:Knob proteins in falciparum malaria. 929 76


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