{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:59:40Z","timestamp":1790837980558,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Noul Inc."}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Sensitive and accurate malaria diagnosis is required for case management to accelerate control efforts. Diagnosis is particularly challenging where multiple <jats:italic>Plasmodium<\/jats:italic> species are endemic, and where <jats:italic>P<\/jats:italic>. <jats:italic>falciparum hrp2<\/jats:italic>\/<jats:italic>3<\/jats:italic> deletions are frequent. The Noul miLab is a fully automated portable digital microscope that prepares a blood film from a droplet of blood, followed by staining and detection of parasites by an algorithm. Infected red blood cells are displayed on the screen of the instrument. Time-to-result is approximately 20 minutes, with less than two minutes hands-on time. We evaluated the miLab among 659 suspected malaria patients in Gondar, Ethiopia, where <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> and <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> are endemic, and the frequency of <jats:italic>hrp2<\/jats:italic>\/<jats:italic>3<\/jats:italic> deletions is high, and 991 patients in Ghana, where <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> transmission is intense. Across both countries combined, the sensitivity of the miLab for <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> was 94.3% at densities &gt;200 parasites\/\u03bcL by qPCR, and 83% at densities &gt;20 parasites\/\u03bcL. The miLab was more sensitive than local microscopy, and comparable to RDT. In Ethiopia, the miLab diagnosed 51\/52 (98.1%) of <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infections with <jats:italic>hrp2<\/jats:italic> deletion at densities &gt;20 parasites\/\u03bcL. Specificity of the miLab was 94.0%. For <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> diagnosis in Ethiopia, the sensitivity of the miLab was 97.0% at densities &gt;200 parasites\/\u03bcL (RDT: 76.8%, microscopy: 67.0%), 93.9% at densities &gt;20 parasites\/\u03bcL, and specificity was 97.6%. In Ethiopia, where <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> and <jats:italic>P<\/jats:italic>. <jats:italic>vivax<\/jats:italic> were frequent, the miLab assigned the wrong species to 15\/195 mono-infections at densities &gt;20 parasites\/\u03bcL by qPCR, and identified only 5\/18 mixed-species infections correctly. In conclusion, the miLab was more sensitive than microscopy and thus is a valuable addition to the toolkit for malaria diagnosis, particularly for areas with high frequencies of <jats:italic>hrp2<\/jats:italic>\/<jats:italic>3<\/jats:italic> deletions.<\/jats:p>","DOI":"10.1371\/journal.pgph.0003091","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T17:50:24Z","timestamp":1716227424000},"page":"e0003091","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["A digital microscope for the diagnosis of Plasmodium falciparum and Plasmodium vivax, including P. falciparum with hrp2\/hrp3 deletion"],"prefix":"10.1371","volume":"4","author":[{"given":"Yalemwork","family":"Ewnetu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7886-5528","authenticated-orcid":true,"given":"Kingsley","family":"Badu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Carlier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A.","family":"Vera-Arias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5879-7695","authenticated-orcid":true,"given":"Emma V","family":"Troth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-6823","authenticated-orcid":true,"given":"Abdul-Hakim","family":"Mutala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-5332","authenticated-orcid":true,"given":"Stephen Opoku","family":"Afriyie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Kwame","family":"Addison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nega","family":"Berhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wossenseged","family":"Lemma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9354-0414","authenticated-orcid":true,"given":"Cristian","family":"Koepfli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"pgph.0003091.ref001","unstructured":"World Health Organisation. 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