{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T08:38:17Z","timestamp":1776069497242,"version":"3.50.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"US Presidents Malaria Initiative"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p><jats:italic>Plasmodium<\/jats:italic> blood-stage infections can be identified by assaying for protein products expressed by the parasites. While the binary result of an antigen test is sufficient for a clinical result, greater nuance can be gathered for malaria infection status based on quantitative and sensitive detection of <jats:italic>Plasmodium<\/jats:italic> antigens and machine learning analytical approaches.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Three independent malaria studies performed in Angola and Haiti enrolled persons at health facilities and collected a blood sample. Presence and parasite density of <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infection was determined by microscopy for a study in Angola in 2015 (n = 193), by qRT-PCR for a 2016 study in Angola (n = 208), and by qPCR for a 2012\u20132013 Haiti study (n = 425). All samples also had bead-based detection and quantification of three <jats:italic>Plasmodium<\/jats:italic> antigens: pAldolase, pLDH, and HRP2. Decision trees and principal component analysis (PCA) were conducted in attempt to categorize <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> parasitemia density status based on continuous antigen concentrations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Conditional inference trees were trained using the known <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infection status and corresponding antigen concentrations, and PCR infection status was predicted with accuracies ranging from 73\u201396%, while level of parasite density was predicted with accuracies ranging from 59\u201372%. Multiple decision nodes were created for both pAldolase and HRP2 antigens. For all datasets, dichotomous infectious status was more accurately predicted when compared to categorization of different levels of parasite densities. PCA was able to account for a high level of variance (&gt;80%), and distinct clustering was found in both dichotomous and categorical infection status.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This pilot study offers a proof-of-principle of the utility of machine learning approaches to assess <jats:italic>P<\/jats:italic>. <jats:italic>falciparum<\/jats:italic> infection status based on continuous concentrations of multiple <jats:italic>Plasmodium<\/jats:italic> antigens.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275096","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T19:26:09Z","timestamp":1664479569000},"page":"e0275096","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predicting Plasmodium falciparum infection status in blood using a multiplexed bead-based antigen detection assay and machine learning approaches"],"prefix":"10.1371","volume":"17","author":[{"given":"Sarah E.","family":"Schmedes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael P.","family":"Dimbu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Steinhardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean F.","family":"Lemoine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle A.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-4625","authenticated-orcid":true,"given":"Mateusz","family":"Plucinski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-8304","authenticated-orcid":true,"given":"Eric","family":"Rogier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"pone.0275096.ref001","unstructured":"World Health Organization. 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