Improvement of malaria diagnostic system based on acridine orange staining

Masatsugu Kimura, Isao Teramoto, Chim W. Chan, Zulkarnain Md Idris, James Kongere, Wataru Kagaya, Fumihiko Kawamoto, Ryoko Asada, Rie Isozumi, Akira Kaneko

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Rapid diagnosis of malaria using acridine orange (AO) staining and a light microscope with a halogen lamp and interference filter was deployed in some malaria-endemic countries. However, it has not been widely adopted because: (1) the lamp was weak as an excitation light and the set-up did not work well under unstable power supply; and, (2) the staining of samples was frequently inconsistent. Methods: The halogen lamp was replaced by a low-cost, blue light-emitting diode (LED) lamp. Using a reformulated AO solution, the staining protocol was revised to make use of a concentration gradient instead of uniform staining. To evaluate this new AO diagnostic system, a pilot field study was conducted in the Lake Victoria basin in Kenya. Results: Without staining failure, malaria infection status of about 100 samples was determined on-site per one microscopist per day, using the improved AO diagnostic system. The improved AO diagnosis had both higher overall sensitivity (46.1 vs 38.9%: p = 0.08) and specificity (99.0 vs 96.3%) than the Giemsa method (N = 1018), using PCR diagnosis as the standard. Conclusions: Consistent AO staining of thin blood films and rapid evaluation of malaria parasitaemia with the revised protocol produced superior results relative to the Giemsa method. This AO diagnostic system can be set up easily at low cost using an ordinary light microscope. It may supplement rapid diagnostic tests currently used in clinical settings in malaria-endemic countries, and may be considered as an inexpensive tool for case surveillance in malaria-eliminating countries.

Original languageEnglish
Article number72
JournalMalaria Journal
Volume17
Issue number1
DOIs
Publication statusPublished - 7 Feb 2018

Fingerprint

Acridine Orange
Malaria
Staining and Labeling
Light
Halogens
Electric Power Supplies
Costs and Cost Analysis
Parasitemia
Victoria
Kenya
Lakes
Routine Diagnostic Tests
Polymerase Chain Reaction
Infection

Keywords

  • Acridine orange
  • Fluorochrome
  • Interference filter
  • LED
  • Malaria diagnosis
  • Staining

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

Cite this

Kimura, M., Teramoto, I., Chan, C. W., Md Idris, Z., Kongere, J., Kagaya, W., ... Kaneko, A. (2018). Improvement of malaria diagnostic system based on acridine orange staining. Malaria Journal, 17(1), [72]. https://doi.org/10.1186/s12936-018-2214-8

Improvement of malaria diagnostic system based on acridine orange staining. / Kimura, Masatsugu; Teramoto, Isao; Chan, Chim W.; Md Idris, Zulkarnain; Kongere, James; Kagaya, Wataru; Kawamoto, Fumihiko; Asada, Ryoko; Isozumi, Rie; Kaneko, Akira.

In: Malaria Journal, Vol. 17, No. 1, 72, 07.02.2018.

Research output: Contribution to journalArticle

Kimura, M, Teramoto, I, Chan, CW, Md Idris, Z, Kongere, J, Kagaya, W, Kawamoto, F, Asada, R, Isozumi, R & Kaneko, A 2018, 'Improvement of malaria diagnostic system based on acridine orange staining', Malaria Journal, vol. 17, no. 1, 72. https://doi.org/10.1186/s12936-018-2214-8
Kimura, Masatsugu ; Teramoto, Isao ; Chan, Chim W. ; Md Idris, Zulkarnain ; Kongere, James ; Kagaya, Wataru ; Kawamoto, Fumihiko ; Asada, Ryoko ; Isozumi, Rie ; Kaneko, Akira. / Improvement of malaria diagnostic system based on acridine orange staining. In: Malaria Journal. 2018 ; Vol. 17, No. 1.
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