A Near-Infrared "Matchbox Size" Spectrometer to Detect and Quantify Malaria Parasitemia

New point-of-care diagnostic approaches for malaria that are sensitive to low parasitemia, easy to use in a field setting, and affordable are urgently required to meet the World Health Organization's objective of reducing malaria cases and related life losses by 90% globally on or before 2030. In this study, an inexpensive "matchbox size" near-infrared (NIR) spectrophotometer was used for the first time to detect and quantify malaria infection in vitro from isolated dried red blood cells using a fingerpick volume of blood. This the first study to apply a miniaturized NIR device to diagnose a parasitic infection and identify marker bands indicative of malaria infection in the NIR region. An NIR device has many advantages including wavelength accuracy and repeatability, speed, resolution, and a greatly improved signal-to-noise ratio compared to existing spectroscopic options. Using multivariate data analysis, we discriminated control red blood cells from infected cells and established the limit of detection of the technique. Principal component analysis displayed a good separation between the infected and uninfected RBCs, while partial least-squares regression analysis yielded a robust parasitemia prediction with root-mean-square error of prediction values of 0.446 and 0.001% for the higher and lower parasitemia models, respectively. The R² values of the higher and lower parasitemia models were 0.947 and 0.931, respectively. Finally, an estimated parasitemia detection limit of 0.00001% and a qunatification limit of 0.001% was achieved; to ascertain the true efficacy of the technique for point-of-care screening, clinical studies using large patient numbers are required, which is the subject of future studies.