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Updated: Sep 16, 2025
In Vivo Assessment of Rodent Plasmodium Parasitemia and Merozoite Invasion by Flow Cytometry
Published on: April 5, 2015
Remoscope: a label-free imaging cytometer for malaria diagnostics
Paul M Lebel1, Ilakkiyan Jeyakumar1, Michelle W L Khoo1
1Department of Bioengineering, Chan Zuckerberg Biohub San Francisco, 499 Illinois Street, San Francisco, CA 94158, USA.
Background:
Malaria diagnostic testing remains a burden on healthcare systems. Here we present Remoscope, a portable imaging cytometer that scans fresh, unstained whole blood using a custom neural network running on low-cost hardware. Remoscope performs label-free, quantitative, stage-specific detection of Plasmodium falciparum (Pf) by screening up to 2 million red blood cells (RBCs) in 1-12 min, without sample fixation, staining or slide scanning. Low-cost disposable cartridges are used to confine flowing blood to an ultrathin sheet for imaging.
Methods:
Performance was benchmarked in vitro by titration of cultured Pf (17.1-710 000 parasites/µl) into whole blood. A study of Remoscope's diagnostic accuracy was evaluated in a cohort of 500 individuals in eastern Uganda, comprising 601 unique clinic visits. Parallel measurements of parasitaemia were performed using Remoscope, quantitative polymerase chain reaction (qPCR) and thick blood smears.
Results:
Clinically, Remoscope's 10× diluted blood assay had a limit of detection with respect to qPCR of 95.1 parasites/µl, sensitivity of 83%, specificity of 96%, positive predictive value of 91% and negative predictive value of 93%.
Conclusions:
Remoscope's speed, accuracy, cost and ease of use address key challenges in malaria diagnosis worldwide. In this pilot study, the diagnostic accuracy approaches that of expert thick smears performed in duplication.
