Diagnosis of Plasmodium falciparum Malaria at Delivery: Comparison of Blood Film Preparation Methods and of Blood Films with Histology

Rogerson, Stephen J.; Mkundika, Patrick; Kanjala, Maxwell K.

doi:10.1128/jcm.41.4.1370-1374.2003

Cited by 113Malaria Research and ControlHemoglobinopathies and Related DisordersBird parasitology and diseases

Diagnosis of Plasmodium falciparum Malaria at Delivery: Comparison of Blood Film Preparation Methods and of Blood Films with Histology

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Rogerson, Stephen J., Mkundika, Patrick, Kanjala, Maxwell K.·2003·Journal of Clinical Microbiology

DOI 10.1128/jcm.41.4.1370-1374.2003PMC PMC153918

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Abstract

We compared peripheral and placental blood films (made by different techniques) with placental histology for diagnosis of Plasmodium falciparum malaria in pregnancy. Samples from 464 women were examined, of whom 124 (26.7%) had active P. falciparum infection and 148 (31.9%) had past infection. Placental histology was more sensitive (91%) than peripheral blood film (47%) or placental blood film (63%) examination and also detected past infection. Few women had microscopically detectable infection without a positive histology. Infection detected by histology only and past infection were both associated with significantly lower infant birth weight and with lower hemoglobin concentrations compared to the results for uninfected women. Thick blood films were prepared with blood obtained by placental incision or scraping of the incision margin (263 samples) or by washing of placental tissue (235 samples). Each gave similar sensitivities (76 to 78%), specificities (98 to 99%), positive predictive values (92 to 98%), and negative predictive values (93 to 94%); but the median levels of parasitemia were lower for incision samples (840 parasites/ micro l) than scrapings (2,295 parasites/ micro l) (P = 0.02). Placental histology is the most sensitive method for the diagnosis of malaria in pregnancy. Methods for preparation of placental films may affect the density, but not the prevalence, of P. falciparum infection detected.

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In other contexts, satisfactory accuracy parameters have been reported for P. falciparum placental malaria even in low and moderate parasitemia, with sensitivity ranging between 76% and 78%.
“In other contexts, satisfactory accuracy parameters have been reported for P. falciparum PM even in low (less than 1000 parasites/µL) and moderate (1000–10,000 parasites/µL) parasitemia, with sensitivity ranging between 76% and 78% [30].”
From Diagnostic Accuracy of a Thick Blood Smear Compared to qPCR for Malaria Associated with Pregnancy in Colombia (2023) · cites this paper as [30]
The predominance of P. vivax in GM is novel in this field of research, where evaluations of diagnostic accuracy predominate in areas with a higher frequency of P. falciparum.
“which is novel in this field of research, where evaluations of diagnostic accuracy predominate in areas with a higher frequency of P. falciparum [28,29,30]”
From Diagnostic Accuracy of a Thick Blood Smear Compared to qPCR for Malaria Associated with Pregnancy in Colombia (2023) · cites this paper as [30]
Placental histology was found to be more sensitive than placental blood smear in several studies, with diagnoses by histology occurring at a rate 1.2-1.7-fold higher than placental blood smear.
“Placental histology was also found to be more sensitive than placental BS in several studies, with diagnoses by histology occurring at a rate 1.2–1.7-fold higher than placental BS [16,69–71].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [70]

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Authors: Rogerson, S. J., Mkundika, P., & Kanjala, M. K.
Affiliations: The Royal Melbourne Hospital (AU)
University of Malawi (MW)
Corresponding author: Rogerson, Stephen J.
ORCID: Rogerson, Stephen J.
Venue: Journal of Clinical Microbiology
Publisher: American Society for Microbiology
Published: 2003-04
Volume: 41
Issue: 4
Pages: 1370-1374
ISSN: 0095-1137 (ISSN-L)
1098-660X
DOI: 10.1128/jcm.41.4.1370-1374.2003
PMC: PMC153918
OpenAlex: W2144700918
Cited by: 113
References: 25
Citations by year: 2025: 3 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 7 · 2019: 5 · 2017: 7 · 2016: 7 · 2015: 2 · 2014: 11 · 2013: 5 · 2012: 8
FWCI: 5.43
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Journal of Clinical Microbiology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Wellcome Trust (046012)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
Keywords: Plasmodium falciparum, malaria in pregnancy, placental histology, peripheral blood smear, parasitemia, birth weight, maternal hemoglobin, diagnostic sensitivity
MeSH terms: Animals, Blood, Blood Specimen Collection, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Placenta, Placenta Diseases, Plasmodium falciparum, Pregnancy, Sensitivity and Specificity, Pregnancy Complications, Parasitic, Malaria, Falciparum, Parasitemia, Delivery, Obstetric

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Diagnosis of Plasmodium falciparum Malaria at Delivery: Comparison of Blood Film Preparation Methods and of Blood Films with Histology

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