Diagnosis of placental malaria in poorly fixed and processed placental tissue

Malaria Journal

Research

Steven R. Meshnick¹  Yunhao Liu²  Jean-Marie M. Kabongo³  Stephen J. Rogerson⁴  Atis Muehlenbachs⁵  Steve M. Taylor⁶  Anya J. Bailis⁷  Sarah H. Landis⁸  Rajni Sharma⁹  Antoinette K. Tshefu^1,10  Jennifer B. Griffin^1,11  David J. Sullivan^1,12 

[1] Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA;Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA;Department of Statistics and Operations Research, University of North Carolina, Chapel Hill, NC, USA;Department of Medical Biology, Service of Pathology, University of Kinshasa Medical School and University Hospital, Kinshasa, Democratic Republic of the Congo;Department of Medicine at Peter Doherty Institute, University of Melbourne, Melbourne, Australia;Department of Pathology, University of Washington, Seattle, WA, USA;Division of Infectious Diseases & International Health and Duke Global Health Institute, Duke University Medical Center, Durham, NC, USA;Division of Maternal–Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Glaxo-Smith-Kline, Worldwide Epidemiology, Uxbridge, Middlesex, UK;Immunopathology Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA;Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo;RTI International, Research Triangle Park, NC, USA;W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

关键词: Malaria;    Histopathology;    PCR;    IHC;    Latent class analysis;    Molecular epidemiology;   

DOI  :  10.1186/s12936-016-1314-6

 received in 2015-09-02, accepted in 2016-04-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPlacental histopathology has been considered the gold standard for diagnosis of malaria during pregnancy. However, in under-resourced areas placental tissue is often improperly fixed and processed; the resulting formalin pigment is difficult to distinguish from malaria pigment. This study examines two alternative diagnostic methods: polymerase chain reaction (PCR) and a novel immunohistochemistry (IHC)-based method using an antibody against histidine-rich protein 2 (HRP2).MethodsPlacental histopathology from 151 pregnant women in Kinshasa was assessed by two blinded microscopists and compared with peripheral blood PCR and IHC for HRP2. The Cohen’s kappa coefficients were calculated to assess the test agreement. The sensitivity and specificity of individual tests were calculated using PCR or IHC as the reference standard as well as latent class analysis (LCA).ResultsPCR and IHC correlated fairly well. The correlation between the two blinded microscopists was poor, as there was widespread formalin pigment. Using LCA, all of the tests had high specificities. The most sensitive test was IHC (67.7 %), with PCR as second-best (56.1 %).ConclusionsPCR and/or IHC are suitable diagnostics when the presence of formalin pigment substantially compromises placental histopathology.

【 授权许可】

CC BY   
© Liu et al. 2016