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Diagnosis of Plasmodium falciparum Malaria at Delivery: Comparison of Blood Film Preparation Methods and of Blood Films with Histology
Open accessAbstract
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 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]
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“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]
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“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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Metadata
- 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
- 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
- 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 (clinical) › 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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