Abstract

Malaria remains a major global health burden, and new methods for low-cost, high-sensitivity, diagnosis are essential, particularly in remote areas with low-resource around the world. In this paper, a cost effective, optical cell-phone based transmission polarized light microscope system is presented for imaging the malaria pigment known as hemozoin. It can be difficult to determine the presence of the pigment from background and other artifacts, even for skilled microscopy technicians. The pigment is much easier to observe using polarized light microscopy. However, implementation of polarized light microscopy lacks widespread adoption because the existing commercial devices have complicated designs, require sophisticated maintenance, tend to be bulky, can be expensive, and would require re-training for existing microscopy technicians. To this end, a high fidelity and high optical resolution cell-phone based polarized light microscopy system is presented which is comparable to larger bench-top polarized microscopy systems but at much lower cost and complexity. The detection of malaria in fixed and stained blood smears is presented using both, a conventional polarized microscope and our cell-phone based system. The cell-phone based polarimetric microscopy design shows the potential to have both the resolution and specificity to detect malaria in a low-cost, easy-to-use, modular platform.

Highlights

  • Malaria remains a major global health burden, and new methods for low-cost, high-sensitivity, diagnosis are essential, in remote areas with low-resource around the world

  • We describe the design of a low-cost, lightweight, high quality mobile-optical-polarization imaging device (MOPID) with similar resolution and field-of-view (FOV) compared to larger bench-top polarized microscopy systems for POC diagnosis of malaria

  • Individual United States Air-Force (USAF) resolution target images (Edmund Optics, Barrington, NJ) are shown in Fig. 2, using both the reference microscope and constructed MOPID device, each equipped for transmission mode imaging

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Summary

Introduction

Malaria remains a major global health burden, and new methods for low-cost, high-sensitivity, diagnosis are essential, in remote areas with low-resource around the world. The recommended gold standard and primary method for evaluating blood samples for malaria detection utilized around the world is the observation of Giemsa-stained thick and thin blood smears via brightfield microscopy This technique offers the ability to detect parasitemia associated with 5–10 parasites in 1 μl of blood[2,3,4]. The current sensitivity threshold for RDT tests is greater than 100 parasites/μl of blood These devices do not provide quantitative parasitemia results and suffer from reported inconsistent performance, in diagnosing strain specific malaria infections[2,6,22]. The minimum concentration of hemozoin that can be measured with polarized light is 15 picograms[2] This hemozoin level is correlated to the lower limit of detection currently reported for parasitemia, namely 30 parasites/μ l of blood[2]

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