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Giglioti R, Filho AEV, Domingos AG, da Silva SS, Cunha RC, Ibelli AMG, Okino CH, de Sena Oliveira MC. Detection and quantification of Babesia bovis and Babesia bigemina using different target genes. Res Vet Sci 2024; 168:105122. [PMID: 38194893 DOI: 10.1016/j.rvsc.2023.105122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Abstract
Molecular assays have been widely used for the detection and quantification of bovine babesiosis due to their high sensitivity and specificity. However, variations in the sensitivity of pathogen detection may occur depending on the selected target gene. Thus, this study aimed to compare the detection sensitivity (DS) of Babesia bovis and B. bigemina infection levels in artificially and naturally infected cattle using quantitative PCR (qPCR) and six target genes. For B. bovis, the merozoite surface antigen genes 2b and 2c (msa-2b and msa-2c), and the mitochondrial cytochrome b gene (cybmt) were used. For B. bigemina, the genes encoding the proteins associated with rhoptry 1c (rap-1c), rap-1a, and cybmt were used. Six bovines, free of babesiosis, were artificially infected with 1 × 10-8 red blood cells infected (iRBC) with B. bovis (n = 3) or 1 × 10-6B. bigemina iRBC (n = 3). The animals were evaluated daily until parasitemia was confirmed (≥ 2.0%). The quantity of iRBC present in each animal was determined by examining blood smears. Blood samples were then subjected to DNA extraction, serial dilution, and qPCR analysis to determine the DS of each target gene. In addition, 30 calves naturally infected by Babesia spp. were also evaluated using the same six target genes. Regarding the artificial infection, B. bovis cybmt showed 25-fold higher sensitivity than the msa-2b and msa-2c genes, while the B. bigemina cybmt exhibited 5-fold and 25-fold higher sensitivity than the rap-1a and rap-1c genes, respectively. The rap-1a gene was found to be 5 times more sensitive than the rap-1c gene, while the B. bovis msa-2b and msa-2c genes exhibited similar DS. The positive frequencies of naturally infected calves for the target cybmt, msa-2b, and msa-2c genes (B. bovis) were: 100%, 33.3% and 50%, while cybmt, rap-1a, and rap-1c genes (B. bigemina) were 90%, 83.3%, and 63.3%, respectively. This study may contribute to the selection of suitable genes for molecular monitoring of bovine babesiosis. Mitochondrial genes could be considered as an alternative to improve the sensitivity of B. bovis and B. bigemina detection using qPCR.
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Affiliation(s)
- Rodrigo Giglioti
- Instituto de Zootecnia, Rua Heitor Penteado, n. 56, Nova Odessa, São Paulo 13380-011, Brazil.
| | | | | | - Sérgio Silva da Silva
- C.R.O. Animal Science, Estrada Colônia São Domingos, Colônia, Turuçú, Rio Grande do Sul, Brazil
| | - Rodrigo Casquero Cunha
- Laboratório de Biologia Molecular Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Capão do Leão, Rio Grande do Sul, Brazil
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van Dijk NJ, Menting S, Wentink-Bonnema EMS, Broekhuizen-van Haaften PE, Withycombe E, Schallig HDFH, Mens PF. Laboratory evaluation of the miniature direct-on-blood PCR nucleic acid lateral flow immunoassay (mini-dbPCR-NALFIA), a simplified molecular diagnostic test for Plasmodium. Malar J 2023; 22:98. [PMID: 36932372 PMCID: PMC10024383 DOI: 10.1186/s12936-023-04496-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/13/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Point-of-care diagnosis of malaria is currently based on microscopy and rapid diagnostic tests. However, both techniques have their constraints, including poor sensitivity for low parasitaemias. Hence, more accurate diagnostic tests for field use and routine clinical settings are warranted. The miniature direct-on-blood PCR nucleic acid lateral flow immunoassay (mini-dbPCR-NALFIA) is an innovative, easy-to-use molecular assay for diagnosis of malaria in resource-limited settings. Unlike traditional molecular methods, mini-dbPCR-NALFIA does not require DNA extraction and makes use of a handheld, portable thermal cycler that can run on a solar-charged power pack. Result read-out is done using a rapid lateral flow strip enabling differentiation of Plasmodium falciparum and non-falciparum malaria infections. A laboratory evaluation was performed to assess the performance of the mini-dbPCR-NALFIA for diagnosis of pan-Plasmodium and P. falciparum infections in whole blood. METHODS Diagnostic accuracy of the mini-dbPCR-NALFIA was determined by testing a set of Plasmodium-positive blood samples from returned travellers (n = 29), and Plasmodium-negative blood samples from travellers with suspected malaria (n = 23), the Dutch Blood Bank (n = 19) and intensive care patients at the Amsterdam University Medical Centers (n = 16). Alethia Malaria (LAMP) with microscopy for species differentiation were used as reference. Limit of detection for P. falciparum was determined by 23 measurements of a dilution series of a P. falciparum culture. A fixed sample set was tested three times by the same operator to evaluate the repeatability, and once by five different operators to assess the reproducibility. RESULTS Overall sensitivity and specificity of the mini-dbPCR-NALFIA were 96.6% (95% CI, 82.2%-99.9%) and 98.3% (95% CI, 90.8%-100%). Limit of detection for P. falciparum was 10 parasites per microlitre of blood. The repeatability of the assay was 93.7% (95% CI, 89.5%-97.8%) and reproducibility was 84.6% (95% CI, 79.5%-89.6%). CONCLUSIONS Mini-dbPCR-NALFIA is a sensitive, specific and robust method for molecular diagnosis of Plasmodium infections in whole blood and differentiation of P. falciparum. Incorporation of a miniature thermal cycler makes the assay well-adapted to resource-limited settings. A phase-3 field trial is currently being conducted to evaluate the potential implementation of this tool in different malaria transmission areas.
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Affiliation(s)
- Norbert J van Dijk
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Institute for Infection and Immunity, Infectious Diseases Programme, Amsterdam, The Netherlands.
| | - Sandra Menting
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Ellen M S Wentink-Bonnema
- Department of Medical Microbiology and Infection Prevention, Clinical Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Patricia E Broekhuizen-van Haaften
- Department of Medical Microbiology and Infection Prevention, Clinical Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Elen Withycombe
- Abingdon Health. York Biotech Campus, Sand Hutton, York, YO41 1LZ, UK
| | - Henk D F H Schallig
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases Programme, Amsterdam, The Netherlands
| | - Petra F Mens
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology. Meibergdreef 9, Amsterdam University Medical Centres, Academic Medical Centre at the University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases Programme, Amsterdam, The Netherlands
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Kumari P, Sinha S, Gahtori R, Quadiri A, Mahale P, Savargaonkar D, Pande V, Srivastava B, Singh H, Anvikar AR. Comparative Assessment of Diagnostic Performance of Cytochrome Oxidase Multiplex PCR and 18S rRNA Nested PCR. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:295-299. [PMID: 36041492 PMCID: PMC9441448 DOI: 10.3347/kjp.2022.60.4.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/16/2022] [Indexed: 11/23/2022]
Abstract
Malaria elimination and control require prompt and accurate diagnosis for treatment plan. Since microscopy and rapid diagnostic test (RDT) are not sensitive particularly for diagnosing low parasitemia, highly sensitive diagnostic tools are required for accurate treatment. Molecular diagnosis of malaria is commonly carried out by nested polymerase chain reaction (PCR) targeting 18S rRNA gene, while this technique involves long turnaround time and multiple steps leading to false positive results. To overcome these drawbacks, we compared highly sensitive cytochrome oxidase gene-based single-step multiplex reaction with 18S rRNA nested PCR. Cytochrome oxidase (cox) genes of P. falciparum (cox-III) and P. vivax (cox-I) were compared with 18S rRNA gene nested PCR and microscopy. Cox gene multiplex PCR was found to be highly specific and sensitive, enhancing the detection limit of mixed infections. Cox gene multiplex PCR showed a sensitivity of 100% and a specificity of 97%. This approach can be used as an alternative diagnostic method as it offers higher diagnostic performance and is amenable to high throughput scaling up for a larger sample size at low cost.
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Affiliation(s)
- Preeti Kumari
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
- Kumaun University, Nainital, Uttarakhand, India
| | - Swati Sinha
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
- Kumaun University, Nainital, Uttarakhand, India
| | - Renuka Gahtori
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
- Kumaun University, Nainital, Uttarakhand, India
| | - Afshana Quadiri
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
| | - Paras Mahale
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
- Kumaun University, Nainital, Uttarakhand, India
| | | | - Veena Pande
- Kumaun University, Nainital, Uttarakhand, India
| | - Bina Srivastava
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
| | - Himmat Singh
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
| | - Anupkumar R Anvikar
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
- Corresponding author ()
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Aschar M, Sanchez MCA, Costa-Nascimento MDJ, Farinas MDLRN, Hristov AD, Lima GFMC, Inoue J, Levi JE, Di Santi SM. Ultrasensitive molecular tests for Plasmodium detection: applicability in control and elimination programs and reference laboratories. Rev Panam Salud Publica 2022; 46:e11. [PMID: 35355692 PMCID: PMC8959250 DOI: 10.26633/rpsp.2022.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Objective. To evaluate molecular tools to detect low-level parasitemia and the five species of Plasmodium that infect humans for use in control and elimination programs, and in reference laboratories. Methods. We evaluated 145 blood samples from patients who tested positive by nested polymerase chain reaction (nPCR), from asymptomatic individuals and from the WHO Global Malaria Programme/United Kingdom National External Quality Assessment Service. Samples were assayed using the genus-specific RealStar® Malaria PCR Kit 1.0 (alt-Gen; altona Diagnostics) and the RealStar® Malaria Screen & Type PCR Kit (alt-S&T; altona Diagnostics). The results from the molecular tests were compared with those from quantitative PCR (qPCR), nPCR and thick blood smear. Results. The levels of parasitemia ranged from 1 to 518 000 parasites/µL, depending on the species. Compared with nPCR, alt-S&T had a sensitivity of 100%, except for identifying P. falciparum, for which the sensitivity was 93.94%. All samples positive by alt-Gen were also positive by nPCR. When comparing alt-Gen to qPCR, the sensitivity was 100% for P. vivax, P. malariae and P. falciparum. For all Plasmodium species, the correlation between cycle threshold values of alt-S&T and alt-Gen compared with qPCR was significant (P < 0.0001, Spearman’s test), with r = 0.8621 for alt-S&T and r = 0.9371 for alt-Gen. When all Plasmodium species were considered, there was a negative correlation between the level of parasitemia and real-time PCR cycle threshold values (P < 0.0001). In this study, only 2 of 28 samples from asymptomatic individuals were positive by thick blood smear; however, all 28 of these samples were positive by alt-S&T. Conclusions. The alt-Gen and alt-S&T assays are suitable for detecting submicroscopic infections for distinct epidemiological purposes, such as for use in surveys and reference laboratories, and screening in blood banks, which will contribute to global efforts to eliminate malaria.
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Affiliation(s)
- Mariana Aschar
- Faculdade de Medicina Universidade de São Paulo São Paulo Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Carmen A Sanchez
- Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria de Jesus Costa-Nascimento
- Secretaria de Estado da Saúde de São Paulo/Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil Secretaria de Estado da Saúde de São Paulo/Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria de Lourdes R N Farinas
- Faculdade de Medicina Universidade de São Paulo São Paulo Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Angélica D Hristov
- Faculdade de Medicina Universidade de São Paulo São Paulo Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Giselle F M C Lima
- Faculdade de Medicina Universidade de São Paulo São Paulo Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Juliana Inoue
- Faculdade de Medicina Universidade de São Paulo São Paulo Brazil Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José E Levi
- Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Silvia M Di Santi
- Secretaria de Estado da Saúde de São Paulo/Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil Secretaria de Estado da Saúde de São Paulo/Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Onken A, Haanshuus CG, Miraji MK, Marijani M, Kibwana KO, Abeid KA, Mørch K, Reimers M, Langeland N, Müller F, Jenum PA, Blomberg B. Malaria prevalence and performance of diagnostic tests among patients hospitalized with acute undifferentiated fever in Zanzibar. Malar J 2022; 21:54. [PMID: 35183188 PMCID: PMC8858509 DOI: 10.1186/s12936-022-04067-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Background Control efforts in Zanzibar reduced the burden of malaria substantially from 2000 to 2015, but re-emergence of falciparum malaria has been observed lately. This study evaluated the prevalence of malaria and performance of routine diagnostic tests among hospitalized fever patients in a 1.5 years period in 2015 and 2016. Methods From March 2015 to October 2016, paediatric and adult patients hospitalized with acute undifferentiated fever at Mnazi Mmoja Hospital, Zanzibar were included. The malaria prevalence, and performance of rapid diagnostic test (RDT) and microscopy, were assessed using polymerase chain reaction (PCR) as gold standard. Results The malaria prevalence was 9% (63/731). Children under 5 years old had lower malaria prevalence (5%, 14/260) than older children (15%, 20/131, p = 0.001) and persons aged 16 to 30 years (13%, 15/119, p = 0.02), but not different from persons over 30 years old (6%, 14/217, p = 0.7). All cases had Plasmodium falciparum infection, except for one case of Plasmodium ovale. Ten malaria patients had no history of visiting mainland Tanzania. The RDT had a sensitivity of 64% (36/56) and a specificity of 98% (561/575), and microscopy had a sensitivity of 50% (18/36) and a specificity of 99% (251/254), compared to PCR. The malaria parasitaemia was lower in patients with false negative results on RDT (median 7 × 103 copies/µL, interquartile range [IQR] 2 × 103 – 8 × 104, p = 0.002) and microscopy (median 9 × 103 copies/µL, IQR 8 × 102 – 7 × 104, p = 0.006) compared to those with true positive RDT (median 2 × 105 copies/µL, IQR 3 × 104 – 5 × 105) and microscopy (median 2 × 105 copies/µL, IQR 6 × 104 – 5 × 105). Conclusions The study emphasizes that malaria was a frequent cause of febrile illness in hospitalized patients in Zanzibar in the years 2015-2016, particularly among school age children and young adults. We found evidence of autochthonous malaria transmission in Zanzibar. Compared to PCR, both RDT and microscopy had low sensitivity, and false negative results were associated with low parasitaemia. While low parasitaemia identified only by PCR in a semi-immune individual could be coincidental and without clinical relevance, clinicians should be aware of the risk of false negative results on routine tests.
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Sharma S, Kumar S, Ahmed MZ, Bhardwaj N, Singh J, Kumari S, Savargaonkar D, Anvikar AR, Das J. Advanced Multiplex Loop Mediated Isothermal Amplification (mLAMP) Combined with Lateral Flow Detection (LFD) for Rapid Detection of Two Prevalent Malaria Species in India and Melting Curve Analysis. Diagnostics (Basel) 2021; 12:32. [PMID: 35054201 PMCID: PMC8774969 DOI: 10.3390/diagnostics12010032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/24/2022] Open
Abstract
Isothermal techniques with lateral flow detection have emerged as a point of care (POC) technique for malaria, a major parasitic disease in tropical countries such as India. Plasmodium falciparum and Plasmodium vivax are the two most prevalent malaria species found in the country. An advanced multiplex loop-mediated isothermal amplification (mLAMP) combined with a lateral flow dipstick (LFD) technique was developed for the swift and accurate detection of P. falciparum and P. vivax, overcoming the challenges of the existing RDTs (rapid diagnostic tests). A single set of LAMP primers with a biotinylated backward inner primer (BIP primer) was used for DNA amplification of both malaria species in a single tube. The amplified DNA was hybridized with fluorescein isothiocyanate (FITC) and digoxigenin-labelled DNA probes, having a complemented sequence for the P. falciparum and P. vivax genomes, respectively. A colour band appeared on two separate LFDs for P. falciparum and P. vivax upon running the hybridized solution over them. In total, 39 clinical samples were collected from ICMR-NIMR, New Delhi. Melting curve analysis, with cross primers for both species, was used to ascertain specificity, and the sensitivity was equated with a polymerase chain reaction (PCR). The results were visualized on the LFD for both species within 60 min. We found 100% sensitivity and specificity, when compared with a traditional PCR. Melting curve analysis of mLAMP revealed the lowest detection limit of 0.15 pg/μL from sample genomic DNA. The mLAMP-LFD assays could be a potential point of care (POC) tool for early diagnosis in non-laboratory conditions, with the convenience of a reduced assay time and the simple interpretation of results.
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Affiliation(s)
| | | | | | | | | | | | | | - Anupkumar R. Anvikar
- Parasite Host Biology, ICMR-National Institute of Malaria Research, New Delhi 110077, India; (S.S.); (S.K.); (M.Z.A.); (N.B.); (J.S.); (S.K.); (D.S.)
| | - Jyoti Das
- Parasite Host Biology, ICMR-National Institute of Malaria Research, New Delhi 110077, India; (S.S.); (S.K.); (M.Z.A.); (N.B.); (J.S.); (S.K.); (D.S.)
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Calderaro A, Montecchini S, Buttrini M, Piccolo G, Rossi S, Arcangeletti MC, Farina B, De Conto F, Chezzi C. Malaria Diagnosis in Non-Endemic Settings: The European Experience in the Last 22 Years. Microorganisms 2021; 9:microorganisms9112265. [PMID: 34835391 PMCID: PMC8620059 DOI: 10.3390/microorganisms9112265] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
Accurate, prompt, and reliable tools for the diagnosis of malaria are crucial for tracking the successes or drawbacks of control and elimination efforts, and for future programs aimed at global malaria eradication. Although microscopy remains the gold standard method, the number of imported malaria cases and the risk of reappearance of autochthonous cases stimulated several laboratories located in European countries to evaluate methods and algorithms suited to non-endemic settings, where skilled microscopists are not always available. In this review, an overview of the field evaluation and a comparison of the methods used for the diagnosis of malaria by European laboratories is reported, showing that the development of numerous innovations is continuous. In particular, the combination of rapid diagnostic tests and molecular assays with microscopy represents a reliable system for the early diagnosis of malaria in non-endemic settings.
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Affiliation(s)
- Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
- Correspondence: ; Tel.: +39-0521-033499; Fax: +39-0521-993620
| | - Sara Montecchini
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Mirko Buttrini
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Giovanna Piccolo
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Sabina Rossi
- Unit of Clinical Microbiology, University Hospital of Parma, Viale A. Gramsci 14, 43126 Parma, Italy;
| | - Maria Cristina Arcangeletti
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Benedetta Farina
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Flora De Conto
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
| | - Carlo Chezzi
- Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy; (S.M.); (M.B.); (G.P.); (M.C.A.); (B.F.); (F.D.C.); (C.C.)
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Kaaya RD, Kajeguka DC, Matowo JJ, Ndaro AJ, Mosha FW, Chilongola JO, Kavishe RA. Predictive markers of transmission in areas with different malaria endemicity in north-eastern Tanzania based on seroprevalence of antibodies against Plasmodium falciparum. BMC Res Notes 2021; 14:404. [PMID: 34717734 PMCID: PMC8557592 DOI: 10.1186/s13104-021-05818-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/22/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE A community-based cross-sectional study was done to assess Plasmodium falciparum exposure in areas with different malaria endemicity in north-eastern Tanzania using serological markers; PfAMA-1 and PfMSP-119. RESULTS Bondo had a higher seroprevalence 36.6% (188) for PfAMA-1 as compared to Hai 13.8% (33), χ2 = 34.66, p < 0.01. Likewise, Bondo had a higher seroprevalence 201(36.6%) for PfMSP-1 as compared to Hai 41 (17.2%), χ2 = 29.62, p < 0.01. Anti-PfAMA-1 titters were higher in malaria positive individuals (n = 47) than in malaria negative individuals (n = 741) (p = 0.07). Anti-PfMSP-1 antibody concentrations were significantly higher in malaria-positive individuals (n = 47) than in malaria-negative individuals (n = 741) (p = 0.003). Antibody response against PfAMA-1 was significantly different between the three age groups; < 5 years, 5 to 15 years and > 15 years in both sites of Bondo and Hai. Likewise, antibody response against PfMSP-119 was significantly different between the three age groups in the two sites (p < 0.001). We also found significant differences in the anti-PfAMA-1and anti-PfMSP-119 antibody concentrations among the three age groups in the two sites (p = 0.004 and 0.005) respectively. Immunological indicators of P. falciparum exposure have proven to be useful in explaining long-term changes in the transmission dynamics, especially in low transmission settings.
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Affiliation(s)
- Robert D Kaaya
- Departmentof Parasitology and Entomology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania. .,Pan-African Malaria Vector Research Consortium, Moshi, Tanzania.
| | - Debora C Kajeguka
- Department of Microbiology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Johnson J Matowo
- Departmentof Parasitology and Entomology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Pan-African Malaria Vector Research Consortium, Moshi, Tanzania
| | - Arnold J Ndaro
- Kilimanjaro Christian Medical Centre (KCMC), Moshi, Tanzania
| | - Franklin W Mosha
- Departmentof Parasitology and Entomology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Pan-African Malaria Vector Research Consortium, Moshi, Tanzania
| | - Jaffu O Chilongola
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Reginald A Kavishe
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Otterdal K, Berg A, Michelsen AE, Yndestad A, Patel S, Gregersen I, Halvorsen B, Ueland T, Langeland N, Aukrust P. IL-18 and IL-18 binding protein are related to disease severity and parasitemia during falciparum malaria. BMC Infect Dis 2021; 21:1073. [PMID: 34663245 PMCID: PMC8524870 DOI: 10.1186/s12879-021-06751-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Several inflammatory molecules participate in the immune response to malaria. Interleukin (IL)-18 is an inflammatory cytokine activated by NLRP3 inflammasomes. In clinical falciparum malaria, with and without HIV co-infection, data on IL-18 and in particular on its binding protein, IL-18bp, is scarce. METHODS Clinical data and blood samples were collected from adults in Mozambique with P. falciparum infection, with (n = 70) and without (n = 61) HIV co-infection, from HIV-infected patients with similar symptoms without malaria (n = 58) and from healthy controls (n = 52). In vitro studies were performed in endothelial cells using hemozoin crystals. RESULTS (i) IL-18 and IL-18bp were markedly up-regulated during falciparum malaria with particular high levels in malaria patients co-infected with HIV and severe malaria disease. (ii) In the malaria group as a whole, both IL-18 and IL-18bp were positively correlated with disease severity, parasitemia, and endothelial cell activation as assessed by vWF in plasma. (iii) Whereas there was no change in IL-18 levels in malaria patients co-infected with HIV during follow-up, the patients with malaria only had slightly increased IL-18 levels. Further, the IL-18pb levels declined and thereby contributed to an increase in IL-18/IL-18bp ratio in all subgroups of malaria patients. (iv) IL-27, previously shown to be up-regulated in this malaria cohort, markedly induced a release of IL-18bp from endothelial cells in vitro, and notably, this presumably anti-inflammatory effect was counteracted by hemozoin. CONCLUSIONS Our findings suggest that the IL-18 system could be an important mediator in the immune pathogenesis during falciparum malaria, potentially also representing a target for therapy.
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Affiliation(s)
- Kari Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.
| | - Aase Berg
- Department of Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.,Department of Medicine, Central Hospital of Maputo, Maputo, Mozambique
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Sam Patel
- Department of Medicine, Central Hospital of Maputo, Maputo, Mozambique
| | - Ida Gregersen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9019, Tromsø, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, 5021, Bergen, Norway.,Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, 5009, Bergen, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Nydalen, PO Box 4950, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway
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10
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Gimenez AM, Marques RF, Regiart M, Bargieri DY. Diagnostic Methods for Non-Falciparum Malaria. Front Cell Infect Microbiol 2021; 11:681063. [PMID: 34222049 PMCID: PMC8248680 DOI: 10.3389/fcimb.2021.681063] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Malaria is a serious public health problem that affects mostly the poorest countries in the world, killing more than 400,000 people per year, mainly children under 5 years old. Among the control and prevention strategies, the differential diagnosis of the Plasmodium-infecting species is an important factor for selecting a treatment and, consequently, for preventing the spread of the disease. One of the main difficulties for the detection of a specific Plasmodium sp is that most of the existing methods for malaria diagnosis focus on detecting P. falciparum. Thus, in many cases, the diagnostic methods neglect the other non-falciparum species and underestimate their prevalence and severity. Traditional methods for diagnosing malaria may present low specificity or sensitivity to non-falciparum spp. Therefore, there is high demand for new alternative methods able to differentiate Plasmodium species in a faster, cheaper and easier manner to execute. This review details the classical procedures and new perspectives of diagnostic methods for malaria non-falciparum differential detection and the possibilities of their application in different circumstances.
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Affiliation(s)
- Alba Marina Gimenez
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Rodolfo F. Marques
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Matías Regiart
- Department of Fundamental Chemistry, Institute of Chemistry, University of São Paulo, São Paulo, Brazil
| | - Daniel Youssef Bargieri
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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11
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Sazed SA, Kibria MG, Alam MS. An Optimized Real-Time qPCR Method for the Effective Detection of Human Malaria Infections. Diagnostics (Basel) 2021; 11:736. [PMID: 33919020 PMCID: PMC8142979 DOI: 10.3390/diagnostics11050736] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/24/2022] Open
Abstract
Polymerase chain reaction, although an expensive method for the detection of human Plasmodium spp., is still considered the finest for the diagnosis of malaria. The conventional diagnostic PCR is an inexpensive process but consumes a lot of time, reagents and lacks sensitivity. On the other hand, real-time PCR assays currently being used are mostly probe-based expensive methods and sometimes not feasible to detect all the species in a single amplification reaction condition. Here we have established a real-time PCR method that is time and cost effective with a single protocol to detect and distinguish five human Plasmodium species using the existing primers efficiently. The primers used here are being used in the conventional method and the sensitivity as well as specificity of this method has also been immensely improved (100%). The lower limit of detection for Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae are 0.064 parasites/µL, 1.6 parasites/µL, and 0.32 parasites/µL respectively and no cross reactivity was observed. Besides, we have analyzed melt curves that can be used for further species confirmation and validation purposes using multiplex systems. This method, therefore, can be considered as an alternative to the existing lineup for molecular diagnosis of malaria in endemic countries.
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Affiliation(s)
| | | | - Mohammad Shafiul Alam
- Infectious Diseases Division, International Centre for Diarrheal Diseases Research, Bangladesh Mohakhali, Dhaka 1212, Bangladesh; (S.A.S.); (M.G.K.)
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12
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Hu F, Zou Q, Li Y, Zhu G, Zhou H, Zhang M, Tian F, Liu Y, Lu F. A PCR-Based Technique to Track the Geographic Origin of Plasmodium falciparum With 23-SNP Barcode Analysis. Front Public Health 2021; 9:649170. [PMID: 33937177 PMCID: PMC8085391 DOI: 10.3389/fpubh.2021.649170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/12/2021] [Indexed: 11/28/2022] Open
Abstract
Increased population movement has increased the risk of reintroducing parasites to elimination areas and also dispersing drug-resistant parasites to new regions. Therefore, reliable and repeatable methods to trace back to the source of imported infections are essential. The recently developed 23-single-nucleotide polymorphism (SNP) barcode from organellar genomes of mitochondrion (mt) and apicoplast (apico) provides a valuable tool to locate the geographic origin of Plasmodium falciparum. This study aims to explore the feasibility of using the 23-SNP barcode for tracking P. falciparum by polymerase chain reaction and sequencing, while providing geographical haplotypes of isolates that originated from Central Africa. Based on 23-SNP barcode analysis, SNPs were found at seven loci; 27 isolates were confirmed to have originated in West Africa, and this study also showed four isolates from Central Africa (Equatorial Guinea, 3; Republic of Congo, 1) that originated in East Africa. This study provides the sequence data from Central Africa and fills 23-SNP barcode data gaps of sample origins.
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Affiliation(s)
- Fengyue Hu
- Jiangsu Key Laboratory of Experimental and Translational Non-coding RNA Research, School of Medicine, Yangzhou University, Yangzhou, China
| | - Qicheng Zou
- Jiangsu Key Laboratory of Experimental and Translational Non-coding RNA Research, School of Medicine, Yangzhou University, Yangzhou, China
| | - Yinyue Li
- Jiangsu Key Laboratory of Experimental and Translational Non-coding RNA Research, School of Medicine, Yangzhou University, Yangzhou, China
| | - Guoding Zhu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Huayun Zhou
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Meihua Zhang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Fang Tian
- Jiangsu Key Laboratory of Experimental and Translational Non-coding RNA Research, School of Medicine, Yangzhou University, Yangzhou, China
| | - Yaobao Liu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Institute of Parasitic Diseases, Wuxi, China
- Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | - Feng Lu
- Jiangsu Key Laboratory of Experimental and Translational Non-coding RNA Research, School of Medicine, Yangzhou University, Yangzhou, China
- Department of Clinical Laboratory, Affiliated Hospital of Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China
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13
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Lamien-Meda A, Fuehrer HP, Leitsch D, Noedl H. A powerful qPCR-high resolution melting assay with taqman probe in plasmodium species differentiation. Malar J 2021; 20:121. [PMID: 33639949 PMCID: PMC7916309 DOI: 10.1186/s12936-021-03662-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of highly sensitive molecular tools in malaria diagnosis is currently largely restricted to research and epidemiological settings, but will ultimately be essential during elimination and potentially eradication. Accurate diagnosis and differentiation down to species levels, including the two Plasmodium ovale species and zoonotic variants of the disease, will be important for the understanding of changing epidemiological patterns of the disease. METHODS A qPCR-high resolution melting (HRM) method was to detect and differentiate all human Plasmodium species with one forward and one reverse primer set. The HRM detection method was further refined using a hydrolysis probe to specifically discriminate Plasmodium falciparum. RESULTS Out of the 113 samples tested with the developed HRM-qPCR- P. falciparum probe assay, 96 (85.0 %) single infections, 12 (10.6 %) mixed infections, and 5 (4.4 %) were Plasmodium negative. The results were concordant with those of the nested PCR at 98.2 %. The assay limit of detection was varied from 21.47 to 46.43 copies /µl, equivalent to 1-2.11 parasites/µl. All P. falciparum infections were confirmed with the associated Taqman probe. CONCLUSIONS Although the dependence on qPCR currently limits its deployment in resource-limited environments, this assay is highly sensitive and specific, easy to perform and convenient for Plasmodium mono-infection and may provide a novel tool for rapid and accurate malaria diagnosis also in epidemiological studies.
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Affiliation(s)
- Aline Lamien-Meda
- Institute for Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
| | - Hans-Peter Fuehrer
- Institute of Parasitology, University of Veterinary Medicine, Vienna, Austria
| | - David Leitsch
- Institute for Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Harald Noedl
- Malaria Research Initiative Bandarban, Vienna, Austria
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14
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Nolasco O, Infante B, Contreras-Mancilla J, Incardona S, Ding XC, Gamboa D, Torres K. Diagnosis of Plasmodium vivax by Loop-Mediated Isothermal Amplification in Febrile Patient Samples from Loreto, Perú. Am J Trop Med Hyg 2020; 103:1549-1552. [PMID: 32748776 PMCID: PMC7543827 DOI: 10.4269/ajtmh.20-0212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Plasmodium vivax is co-endemic with Plasmodium falciparum in Peru, and optimum management requires distinguishing these two species in the blood of patients. For the differential identification of P. vivax and other Plasmodium spp., the LoopampTM Malaria Pan Detection Kit in combination with the Loopamp Malaria Pv Detection Kit (Eiken Chemical Co. Ltd., Tokyo, Japan) was used to evaluate 559 whole blood samples collected in 2017 from febrile patients with suspected malaria attending different health facilities in the Loreto region. The Loopamp Malaria Pan Detection Kit showed a sensitivity of 87.7% (95% CI: 83.5-91.9) and a specificity of 94.4% (95% CI: 91.9-96.9) and good agreement with PCR (Cohen's kappa 0.8266, 95% CI: 0.7792-0.874). By comparison, the Loopamp Malaria Pv Detection Kit showed a similar sensitivity (84.4%, 95% CI: 79.0-89.7) and specificity (92.4%, 95% CI: 89.7-95.0) and substantial agreement with PCR (Cohen's kappa: 0.7661, 95% CI: 0.7088-0.8234).
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Affiliation(s)
- Oscar Nolasco
- Instituto de Medicina Tropical "Alexander von Humboldt" Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Beronica Infante
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Juan Contreras-Mancilla
- Instituto de Medicina Tropical "Alexander von Humboldt" Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | - Xavier C Ding
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Dionicia Gamboa
- Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú.,Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú.,Instituto de Medicina Tropical "Alexander von Humboldt" Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Katherine Torres
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú.,Instituto de Medicina Tropical "Alexander von Humboldt" Universidad Peruana Cayetano Heredia, Lima, Perú
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15
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Development of a Multiplex Loop-Mediated Isothermal Amplification (LAMP) Method for Simultaneous Detection of Spotted Fever Group Rickettsiae and Malaria Parasites by Dipstick DNA Chromatography. Diagnostics (Basel) 2020; 10:diagnostics10110897. [PMID: 33147773 PMCID: PMC7694008 DOI: 10.3390/diagnostics10110897] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022] Open
Abstract
Spotted fever group (SFG) rickettsiae causes febrile illness in humans worldwide. Since SFG rickettsiosis’s clinical presentation is nonspecific, it is frequently misdiagnosed as other febrile diseases, especially malaria, and complicates proper treatment. Aiming at rapid, simple, and simultaneous detection of SFG Rickettsia spp. and Plasmodium spp., we developed a novel multiple pathogen detection system by combining a loop-mediated isothermal amplification (LAMP) method and dipstick DNA chromatography technology. Two primer sets detecting SFG Rickettsia spp. and Plasmodium spp. were mixed, and amplified products were visualized by hybridizing to dipstick DNA chromatography. The multiplex LAMP with dipstick DNA chromatography distinguished amplified Rickettsia and Plasmodium targeted genes simultaneously. The determined sensitivity using synthetic nucleotides was 1000 copies per reaction for mixed Rickettsia and Plasmodium genes. When genomic DNA from in vitro cultured organisms was used, the sensitivity was 100 and 10 genome equivalents per reaction for Rickettsia monacensis and Plasmodium falciparum, respectively. Although further improvement will be required for more sensitive detection, our developed simultaneous diagnosis technique will contribute to the differential diagnosis of undifferentiated febrile illness caused by either SFG Rickettsia spp. or Plasmodium spp. in resource-limited endemic areas. Importantly, this scheme is potentially versatile for the simultaneous detection of diverse infectious diseases.
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16
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Nuin NA, Tan AF, Lew YL, Piera KA, William T, Rajahram GS, Jelip J, Dony JF, Mohammad R, Cooper DJ, Barber BE, Anstey NM, Chua TH, Grigg MJ. Comparative evaluation of two commercial real-time PCR kits (QuantiFast™ and abTES™) for the detection of Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia. Malar J 2020; 19:306. [PMID: 32854695 PMCID: PMC7457277 DOI: 10.1186/s12936-020-03379-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background The monkey parasite Plasmodium knowlesi is an emerging public health issue in Southeast Asia. In Sabah, Malaysia, P. knowlesi is now the dominant cause of human malaria. Molecular detection methods for P. knowlesi are essential for accurate diagnosis and in monitoring progress towards malaria elimination of other Plasmodium species. However, recent commercially available PCR malaria kits have unpublished P. knowlesi gene targets or have not been evaluated against clinical samples. Methods Two real-time PCR methods currently used in Sabah for confirmatory malaria diagnosis and surveillance reporting were evaluated: the QuantiFast™ Multiplex PCR kit (Qiagen, Germany) targeting the P. knowlesi 18S SSU rRNA; and the abTES™ Malaria 5 qPCR II kit (AITbiotech, Singapore), with an undisclosed P. knowlesi gene target. Diagnostic accuracy was evaluated using 52 P. knowlesi, 25 Plasmodium vivax, 21 Plasmodium falciparum, and 10 Plasmodium malariae clinical isolates, and 26 malaria negative controls, and compared against a validated reference nested PCR assay. The limit of detection (LOD) for each PCR method and Plasmodium species was also evaluated. Results The sensitivity of the QuantiFast™ and abTES™ assays for detecting P. knowlesi was comparable at 98.1% (95% CI 89.7–100) and 100% (95% CI 93.2–100), respectively. Specificity of the QuantiFast™ and abTES™ for P. knowlesi was high at 98.8% (95% CI 93.4–100) for both assays. The QuantiFast™ assay demonstrated falsely-positive mixed Plasmodium species at low parasitaemias in both the primary and LOD analysis. Diagnostic accuracy of both PCR kits for detecting P. vivax, P. falciparum, and P. malariae was comparable to P. knowlesi. The abTES™ assay demonstrated a lower LOD for P. knowlesi of ≤ 0.125 parasites/µL compared to QuantiFast™ with a LOD of 20 parasites/µL. Hospital microscopy demonstrated a sensitivity of 78.8% (95% CI 65.3–88.9) and specificity of 80.4% (95% CI 67.6–89.8) compared to reference PCR for detecting P. knowlesi. Conclusion The QuantiFast™ and abTES™ commercial PCR kits performed well for the accurate detection of P. knowlesi infections. Although the QuantiFast™ kit is cheaper, the abTES™ kit demonstrated a lower LOD, supporting its use as a second-line referral-laboratory diagnostic tool in Sabah, Malaysia.
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Affiliation(s)
- Nor Afizah Nuin
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Angelica F Tan
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia. .,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
| | - Yao Long Lew
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | - Kim A Piera
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Gleneagles Hospital, Kota Kinabalu, Sabah, Malaysia.,Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | | | - Jiloris F Dony
- State Public Health Laboratory, Sabah Department of Health, Kota Kinabalu, Malaysia
| | - Rashidah Mohammad
- State Public Health Laboratory, Sabah Department of Health, Kota Kinabalu, Malaysia
| | - Daniel J Cooper
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
| | - Bridget E Barber
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Nicholas M Anstey
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
| | - Tock H Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Matthew J Grigg
- Infectious Diseases Society Kota Kinabalu - Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia. .,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
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17
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Jones S, Subramaniam G, Plucinski MM, Patel D, Padilla J, Aidoo M, Talundzic E. One-step PCR: A novel protocol for determination of pfhrp2 deletion status in Plasmodium falciparum. PLoS One 2020; 15:e0236369. [PMID: 32702040 PMCID: PMC7377462 DOI: 10.1371/journal.pone.0236369] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023] Open
Abstract
Histidine-rich protein 2 (HRP2) detecting rapid diagnostic tests (RDTs) have played an important role in enabling prompt malaria diagnosis in remote locations. However, emergence of pfhrp2 deleted parasites is threatening the efficacy of RDTs, and the World Health Organization (WHO) has highlighted surveillance of these deletions as a priority. Nested PCR is used to confirm pfhrp2 deletion but is costly and laborious. Due to spurious amplification of paralogue pfhrp3, the identity of nested exon 1 PCR product must be confirmed by sequencing. Here we describe a new one-step PCR method for detection of pfhrp2. To determine sensitivity and specificity, all PCRs were performed in triplicate. Using photo-induced electron transfer (PET) PCR detecting 18srRNA as true positive, one-step had comparable sensitivity of 95.0% (88.7–98.4%) to nested exon 1, 99.0% (94.6–99.9%) and nested exon 2, 98.0% (93.0–99.8%), and comparable specificity 93.8% (69.8–99.8%) to nested exon 1 100.0% (79.4–100.0%) and nested exon 2, 100.0% (74.4–100.0%). Sequencing revealed that one step PCR does not amplify pfhrp3. Logistic regression models applied to measure the 95% level of detection of the one-step PCR in clinical isolates provided estimates of 133p/μL (95% confidence interval (CI): 3-793p/μL) for whole blood (WB) samples and 385p/μL (95% CI: 31–2133 p/μL) for dried blood spots (DBSs). When considering protocol attributes, the one-step PCR is less expensive, faster and more suitable for high throughput. In summary, we have developed a more accurate PCR method that may be ideal for the application of the WHO protocol for investigating pfhrp2 deletions in symptomatic individuals presenting to health care facilities.
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Affiliation(s)
- Sophie Jones
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Williams Consulting, Baltimore, Maryland, United States of America
- * E-mail:
| | - Gireesh Subramaniam
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Atlanta, Georgia, United States of America
| | - Mateusz M. Plucinski
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- President’s Malaria Initiative, Atlanta, Georgia, United States of America
| | - Dhruviben Patel
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Williams Consulting, Baltimore, Maryland, United States of America
| | - Jasmine Padilla
- Oak Ridge Institute for Science and Education, Atlanta, Georgia, United States of America
- Biotechnology Core Facilities Branch, Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Michael Aidoo
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eldin Talundzic
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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18
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Wahab A, Shaukat A, Ali Q, Hussain M, Khan TA, Khan MAU, Rashid I, Saleem MA, Evans M, Sargison ND, Chaudhry U. A novel metabarcoded 18S ribosomal DNA sequencing tool for the detection of Plasmodium species in malaria positive patients. INFECTION GENETICS AND EVOLUTION 2020; 82:104305. [PMID: 32247865 DOI: 10.1016/j.meegid.2020.104305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 02/07/2023]
Abstract
Various PCR based methods have been described for the diagnosis of malaria, but most depend on the use of Plasmodium species-specific probes and primers; hence only the tested species are identified and there is limited available data on the true circulating species diversity. Sensitive diagnostic tools and platforms for their use are needed to detect Plasmodium species in both clinical cases and asymptomatic infections that contribute to disease transmission. We have recently developed for the first time a novel high throughput 'haemoprotobiome' metabarcoded DNA sequencing method and applied it for the quantification of haemoprotozoan parasites (Theleria and Babesia) of livestock. Here, we describe a novel, high throughput method using an Illumina MiSeq platform to demonstrate the proportions of Plasmodium species in metabarcoded DNA samples derived from human malaria patients. Plasmodium falciparum and Plasmodium vivax positive control gDNA was used to prepare mock DNA pools of parasites to evaluate the detection threshold of the assay for each of the two species. The different mock pools demonstrate the accurate detection ability and to show the proportions of each of the species being present. We then applied the assay to malaria-positive human samples to show the species composition of Plasmodium communities in the Punjab province of Pakistan and in the Afghanistan-Pakistan tribal areas. The diagnostic performance of the deep amplicon sequencing method was compared to an immunochromatographic assay that is widely used in the region. The deep amplicon sequencing showed that P. vivax was present in 69.8%, P. falciparum in 29.5% and mixed infection in 0.7% patients examined. The immunochromatographic assay showed that P. vivax was present in 65.6%, P. falciparum in 27.4%, mixed infection 0.7% patients and 6.32% malaria-positive cases were negative in immunochromatographic assay, but positive in the deep amplicon sequencing. Overall, metabarcoded DNA sequencing demonstrates better diagnostic performance, greatly increasing the estimated prevalence of Plasmodium infection. The next-generation sequencing method using metabarcoded DNA has potential applications in the diagnosis, surveillance, treatment, and control of Plasmodium infections, as well as to study the parasite biology.
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Affiliation(s)
- Abdul Wahab
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Ayaz Shaukat
- University of Central Punjab, Lahore, Punjab, Pakistan
| | - Qasim Ali
- Gomal University, Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan
| | - Mubashir Hussain
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | - Taj Ali Khan
- University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan
| | | | - Imran Rashid
- University of Veterinary and Animal Sciences, Lahore, Punjab, Pakistan
| | | | - Mike Evans
- Royal Dick School of Veterinary Studies, University of Edinburgh, UK
| | - Neil D Sargison
- Royal Dick School of Veterinary Studies, University of Edinburgh, UK.
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19
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Otterdal K, Berg A, Michelsen AE, Patel S, Gregersen I, Sagen EL, Halvorsen B, Yndestad A, Ueland T, Langeland N, Aukrust P. Plasma levels of interleukin 27 in falciparum malaria is increased independently of co-infection with HIV: potential immune-regulatory role during malaria. BMC Infect Dis 2020; 20:65. [PMID: 31964363 PMCID: PMC6974969 DOI: 10.1186/s12879-020-4783-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 01/09/2020] [Indexed: 01/08/2023] Open
Abstract
Background The immune response during falciparum malaria mediates both harmful and protective effects on the host; however the participating molecules have not been fully defined. Interleukin (IL)-27 is a pleiotropic cytokine exerting both inflammatory and anti-inflammatory effects, but data on IL-27 in malaria patients are scarce. Methods Clinical data and blood samples were collected from adults in Mozambique with P. falciparum infection, with (n = 70) and without (n = 61) HIV-1 co-infection, from HIV-infected patients with similar symptoms without malaria (n = 58) and from healthy controls (n = 52). In vitro studies were performed in endothelial cells and PBMC using hemozoin crystals. Samples were analyzed using enzyme immunoassays and quantitative PCR. Results (i) IL-27 was markedly up-regulated in malaria patients compared with controls and HIV-infected patients without malaria, showing no relation to HIV co-infection. (ii) IL-27 was correlated with P. falciparum parasitemia and von Willebrand factor as a marker of endothelial activation, but not with disease severity. (iii) In vitro, IL-27 modulated the hemozoin-mediated cytokine response in endothelial cells and PBMC with enhancing effects on IL-6 and attenuating effects on IL-8. Conclusion Our findings show that IL-27 is regulated during falciparum malaria, mediating both inflammatory and anti-inflammatory effects, potentially playing an immune-regulatory role during falciparum malaria.
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Affiliation(s)
- Kari Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.
| | - Aase Berg
- Department of Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.,Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Sam Patel
- Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Ida Gregersen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Ellen Lund Sagen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Arne Yndestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway.,K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9019, Tromsø, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, 5021, Bergen, Norway.,Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, 5009, Bergen, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, 0424, Oslo, Nydalen, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway
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20
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Sharma S, Kaitholia K, Bharti RS, Singh MP, Mishra N. Novel molecular diagnostic technique for detecting the different species of Plasmodium. INFECTION GENETICS AND EVOLUTION 2019; 78:104122. [PMID: 31751755 DOI: 10.1016/j.meegid.2019.104122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/25/2019] [Accepted: 11/16/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sensitive diagnostic techniques are needed for timely detection of malaria parasite and disease control. Molecular diagnostic techniques involving Polymerase chain reaction (PCR) with 18 s rRNA as a known diagnostic target with an overall sensitivity of 10 parasites per microliter is used as a gold standard. Till date, no attempt has been undertaken to develop a technique for the identification of four Plasmodium species in a single step PCR combined with restriction digestion with enzymes. METHOD Plasmodium species-specific polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays have been developed, based on RFLP of amplified PCR product of mitochondrial gene as a target. This approach identifies Plasmodium species in two steps involving amplification of mitochondrial (Mt) gene by PCR followed by digestion with restriction enzymes. RESULT A total of 36 clinical samples were subjected to PCR-RFLP for the diagnosis and detection of malaria parasites targeting mitochondrial gene (Mt). The findings of the method were compared with gold standard methods (Microscopy, RDTs and Nested PCR) and was able to detect mixed infection with a sensitivity of 100% and specificity of 93.8% with respect to nested PCR. The results obtained by PCR-RFLP were validated with Sanger sequencing (n = 32) and were found to be consistent with the method. CONCLUSION This method identifies and distinguishes four species of human malaria parasite namely P. falciparum (Pf), P. vivax (Pv), P. malariae (Pm) and P. ovale (Po) in approximately 4 h. To overcome and address PCR difficulties, continuous efforts are needed for the development of newer diagnostic techniques.
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Affiliation(s)
- Supriya Sharma
- ICMR-National Institute of Malaria Research, New Delhi 110077, India
| | - Kamlesh Kaitholia
- ICMR-National Institute of Malaria Research, New Delhi 110077, India
| | - Ram Suresh Bharti
- ICMR-National Institute of Malaria Research, New Delhi 110077, India
| | | | - Neelima Mishra
- ICMR-National Institute of Malaria Research, New Delhi 110077, India.
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21
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Betgiri AA, Jadhav SN, Pawde M, Shukla A, Mote C, Pawar PD, Shanmugam D, Kundu K. Mitochondrial cytochrome oxidase C subunit III (cox3) gene as a sensitive and specific target for molecular detection of Babesia gibsoni infection in dogs. Exp Parasitol 2019; 206:107771. [PMID: 31585116 DOI: 10.1016/j.exppara.2019.107771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/22/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
A PCR targeting mitochondrial cytochrome oxidase subunit III (cox3) for molecular detection of Babesia gibsoni infection in dogs has been developed in this study. Fifty blood samples from suspected clinical cases from dogs, brought to the veterinary college clinics, were examined for presence of B. gibsoni using conventional diagnosis by microscopic examination of Giemsa stained thin blood smears. In addition, species specific PCRs targeting ITS-1 region (BgITS-1 PCR) and nested PCR targeting 18S ribosomal RNA gene (Bg18SnPCR) were carried out. A 634 bp PCR fragment of B. gibsoni cox3 gene was amplified in positive samples from three geographical locations of Satara, Wai and Pune in Maharashtra state of India. From analysis of the sequence of the B. gibsoni cox3 gene, we found that the Indian isolate had 96-98% similarity to the isolate from Japan and China. Post sequencing, de-novo diagnostic primer pair for species specific amplification of 164 bp fragment of B. gibsonicox3 was designed and the PCR was standardized. The diagnostic results of de-novo Bgcox3 PCR were compared with BgITS-1 PCR and Bg18S nPCR. Thin blood smears detected 22% (11/50) samples positive for small form of Babesia species. The BgITS-1 PCR detected 25% samples (15/50) as positive and Bg18S nPCR detected 80% (40/50) B. gibsoni positive samples. The de-novo Bgcox3 PCR detected 66% (33/50) samples positive for B. gibsoni (at 95% CI). The analytical sensitivity of cox3 PCR was evaluated as 0.000003% parasitaemia or 09 parasites in 100 μl of blood. The de-novo diagnostic cox3 PCR did not cross react with control positive DNA from other haemoprotozoa and rickettsia like B. vogeli, Hepatozoon canis, Trypanosoma evansi, Ehrlichia canis and Anaplasma platys. Statistically, cox3 PCR had better diagnostic efficiency than ITS-1 PCR in terms of sensitivity (p = 0.0006). No statistically significant difference between results of cox3 PCR and 18S nPCR was observed (p = 0.1760). Kappa values estimated for each test pair showed fair to moderate agreement between the observations. Specificity of Bgcox3 PCR was 100% when compared with microscopy or BgITS-1 PCR. Sensitivity of Bgcox3 PCR was 100% when compared with that of Bg18S nPCR.
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Affiliation(s)
- Aishwarya A Betgiri
- Department of Veterinary Parasitology, KNP College of Veterinary Science, Shirwal, India
| | - Sameer N Jadhav
- Department of Veterinary Biochemistry, KNP College of Veterinary Science, Shirwal, India
| | - Mrunalini Pawde
- Department of Veterinary Microbiology, KNP College of Veterinary Science, Shirwal, India
| | - Anurag Shukla
- Biochemical Sciences Division, National Chemical Laboratory, Pune, India; Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Chandrashekhar Mote
- Department of Veterinary Pathology, KNP College of Veterinary Science, Shirwal, India
| | - Prashant D Pawar
- Department of Veterinary Parasitology, KNP College of Veterinary Science, Shirwal, India
| | - Dhanasekaran Shanmugam
- Biochemical Sciences Division, National Chemical Laboratory, Pune, India; Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Krishnendu Kundu
- Department of Veterinary Parasitology, KNP College of Veterinary Science, Shirwal, India.
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22
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Chaudhry U, Ali Q, Rashid I, Shabbir MZ, Ijaz M, Abbas M, Evans M, Ashraf K, Morrison I, Morrison L, Sargison ND. Development of a deep amplicon sequencing method to determine the species composition of piroplasm haemoprotozoa. Ticks Tick Borne Dis 2019; 10:101276. [PMID: 31473098 DOI: 10.1016/j.ttbdis.2019.101276] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/13/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
Abstract
Piroplasmosis is caused by tick-borne haemoprotozoa of the genera Theileria and Babesia. These parasitic infections can seriously impact on the health of livestock and production. Piroplasms of multiple species can be present in a single host, but reliable molecular diagnostic tools are needed in order to understand the composition of these complex parasite communities. Theileria and Babesia vary in their epidemiology, drug sensitivity, pathogenicity and interaction with co-infecting species, but are similar in that infected animals become persistent carriers after recovery from primary infection, acting as reservoir hosts. Here, we describe for the first time the use of a deep amplicon sequencing platform to identify proportions of piroplasm species in co-infecting communities and develop the concept of a "haemoprotobiome". First, four phenotypically-verified species of Theileria and Babesia were used to prepare mock DNA pools with random numbers of the parasites amplified by four different numbers of PCR cycles to assess sequence representation for each species. Second, we evaluated the detection threshold of the deep amplicon sequencing assay for each of the four species and to assess the accuracy of proportional quantification of all four species. Finally, we applied the assay to the field samples to afford insight of the species composition of piroplasm communities in small and large ruminants in the Punjab province of Pakistan. The "haemoprotobiome" concept has several potential applications in veterinary and human research, including understanding of responses to drug treatment; parasite epidemiology and ecology; species interactions during mixed infections; and parasite control strategies.
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Affiliation(s)
- Umer Chaudhry
- Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, Scotland, UK.
| | - Qasim Ali
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Imran Rashid
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | | | - Muhammad Ijaz
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Abbas
- Disease Diagnostic Laboratory, Livestock and Dairy Department, Okara, Pakistan
| | - Mike Evans
- Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, Scotland, UK
| | - Kamran Ashraf
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Ivan Morrison
- Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, Scotland, UK
| | - Liam Morrison
- Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, Scotland, UK
| | - Neil D Sargison
- Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, Scotland, UK
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23
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Kamaliddin C, Le Bouar M, Berry A, Fenneteau O, Gillet P, Godineau N, Candolfi E, Houzé S. Assessment of diagnostic methods for imported malaria in mainland France. Med Mal Infect 2019; 50:141-160. [PMID: 31375372 DOI: 10.1016/j.medmal.2019.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 07/04/2019] [Indexed: 12/29/2022]
Affiliation(s)
- C Kamaliddin
- Centre national de référence du paludisme, hôpital Bichat, 75018 Paris, France
| | - M Le Bouar
- Service de parasitologie-mycologie, CHU de Toulouse, 31300 Toulouse, France
| | - A Berry
- Service de parasitologie-mycologie, CHU de Toulouse, 31300 Toulouse, France
| | - O Fenneteau
- Service d'hématologie biologique, CHU Robert-Debré, AP-HP, 75018 Paris, France
| | - P Gillet
- Department of clinical sciences, institute of tropical medicine, 2000 Anvers, Belgium
| | - N Godineau
- Service de parasitologie, centre hospitalier Delafontaine, 93200 Saint-Denis, France
| | - E Candolfi
- Laboratoire de parasitologie, institut de parasitologie et de pathologie tropicale, hôpitaux civils de Strasbourg, CHU, 67000 Strasbourg, France
| | - S Houzé
- Centre national de référence du paludisme, hôpital Bichat, 75018 Paris, France; Service de parasitologie, hôpital Bichat, AP-HP, 75018 Paris, France.
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24
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Haanshuus CG, Mørch K, Blomberg B, Strøm GEA, Langeland N, Hanevik K, Mohn SC. Assessment of malaria real-time PCR methods and application with focus on low-level parasitaemia. PLoS One 2019; 14:e0218982. [PMID: 31276473 PMCID: PMC6611585 DOI: 10.1371/journal.pone.0218982] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 06/04/2019] [Indexed: 01/04/2023] Open
Abstract
In epidemiological surveys and surveillance the application of molecular tools is essential in detecting submicroscopic malaria. A genus-specific conventional cytochrome b (cytb) PCR has shown high sensitivity in field studies, detecting 70% submicroscopic malaria. The main objective of this study was to assess the conversion from conventional to real-time PCR testing both SYBR and probe protocols, and including quantitative (q) PCR. The protocols were assessed applying well-defined clinical patient material consisting of 33 positive and 80 negative samples. Sequencing of positive PCR products was performed. In addition, a sensitivity comparison of real-time PCR methods was done by including five relevant assays investigating the effect of amplification target and platform. Sensitivity was further examined using field material consisting of 111 P.falciparum positive samples from Tanzanian children (< 5 years), as well as using related patient data to assess the application of q-PCR with focus on low-level parasitaemia. Both the cytb SYBR and probe PCR protocols showed as high sensitivity and specificity as their conventional counterpart, except missing one P. malariae sample. The SYBR protocol was more sensitive and specific than using probe. Overall, choice of amplification target applied is relevant for achieving ultra-sensitivity, and using intercalating fluorescence dye rather than labelled hydrolysis probes is favourable. Application of q-PCR analysis in field projects is important for the awareness and understanding of low-level parasitaemia. For use in clinical diagnosis and epidemiological studies the highly sensitive and user-friendly cytb SYBR q-PCR method is a relevant tool. The genus-specific method has the advantage that species identification by sequencing can be performed as an alternative to species-specific PCR.
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Affiliation(s)
- Christel Gill Haanshuus
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Kristine Mørch
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Nina Langeland
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Kurt Hanevik
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Stein Christian Mohn
- Norwegian National Advisory Unit on Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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25
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Lamien-Meda A, Fuehrer HP, Noedl H. Novel high resolution melting (HRM) and snapback assays for simultaneous detection and differentiation of Plasmodium ovale spp. Acta Trop 2019; 192:75-81. [PMID: 30711423 DOI: 10.1016/j.actatropica.2019.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 01/18/2019] [Accepted: 01/18/2019] [Indexed: 12/16/2022]
Abstract
Plasmodium ovale spp. are two of the six species of apicomplexan parasites belonging to the genus Plasmodium commonly causing disease in humans. A recent phylogeny study has identified both Plasmodium ovale species (P. ovale curtisi and P. ovale wallikeri) as two sympatric occurring species. The actual prevalence and clinical relevance of P. ovale spp. are likely underestimated due to low parasitemia and mixed infections, which pose a major challenge to microscopic diagnosis and are frequently undetectable using malaria Rapid Diagnostic Tests (RDTs). The aim of this work is to develop a HRM-based assay for simultaneous detection and differentiation of P. ovale wallikeri and P. ovale curtisi. Thirty three well-documented P. ovale spp. samples from previous studies were used for this study. The newly developed High Resolution Melting (HRM) assay targeting the apicoplast genome was highly specific to both P. ovale species. Adding a snapback tail at the 5' end of the forward primer for a nested HRM PCR, increased the melting temperature (Tm) difference between the two species. To our knowledge this study reports the first direct HRM assay developed on the apicoplast genome, specific for both P. ovale species. This method provides added value to the WHO open request of developing new practical malaria diagnostic methods for the malaria elimination program and could contribute to a quick and efficient diagnosis of low-level parasitemia, symptomatic or asymptomatic, as well as mixed or single P. ovale infections.
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Affiliation(s)
- Aline Lamien-Meda
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Austria.
| | - Hans-Peter Fuehrer
- Institute of Parasitology, University of Veterinary Medicine, Vienna, Austria
| | - Harald Noedl
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Austria
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26
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Otterdal K, Berg A, Michelsen AE, Patel S, Tellevik MG, Haanshuus CG, Fevang B, Aukrust P, Langeland N, Ueland T. Soluble markers of neutrophil, T-cell and monocyte activation are associated with disease severity and parasitemia in falciparum malaria. BMC Infect Dis 2018; 18:670. [PMID: 30563486 PMCID: PMC6299500 DOI: 10.1186/s12879-018-3593-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/06/2018] [Indexed: 01/15/2023] Open
Abstract
Background The immune response during P. falciparum infection is a two-edged sword, involving dysregulation of the inflammatory responses with several types of immune cells participating. Here we examined T-cell, monocyte/macrophage and neutrophil activation during P. falciparum infection by using soluble activation markers for these leukocyte subsets. Methods In a prospective cross-sectional study clinical data and blood samples were collected from adults in Mozambique with P. falciparum infection, with (n = 70) and without (n = 61) co-infection with HIV-1, as well as HIV-infected patients with similar symptoms but without malaria (n = 58) and healthy controls (n = 52). Soluble (s)CD25, sCD14, sCD163 and myeloperoxidase (MPO) as markers for T-cell, monocyte/macrophage and neutrophil activation, respectively as well as CX3CL1, granzyme B and TIM-3 as markers of T-cell subsets and T-cell exhaustion, were analyzed. Results All patient groups had raised levels of activation markers compared with healthy controls. Levels of sCD25 and MPO increased gradually from patient with HIV only to patient with malaria only, with the highest levels in the HIV/malaria group. In the malaria group as a whole, MPO, sCD14 and in particular sCD25 were correlated with disease severity. sCD163, sCD25 and in particular MPO correlated with the degree of parasitemia as assessed by qPCR. Patients with falciparum malaria also had signs of T-cell subset activation (i.e. increased granzyme B and CX3CL1) and T-cell exhaustion as assessed by high levels of TIM-3 particularly in patients co-infected with HIV. Conclusion Our data support a marked immune activation in falciparum malaria involving all major leukocyte subsets with particular enhanced activation of neutrophils and T-cells in patients co-infected with HIV. Our findings also support a link between immune activation and immune exhaustion during falciparum malaria, particularly in relation to T-cell responses in patients co-infected with HIV. Electronic supplementary material The online version of this article (10.1186/s12879-018-3593-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kari Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.
| | - Aase Berg
- Department of Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.,Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Sam Patel
- Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Marit G Tellevik
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway
| | - Christel G Haanshuus
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway
| | - Børre Fevang
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, 5021, Bergen, Norway.,Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, 5009, Bergen, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway.,K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9019, Tromsø, Norway
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27
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Batista-Dos-Santos SA, Freitas DRC, Raiol M, Cabral GF, Feio AC, Póvoa MM, Cunha MG, Ribeiro-Dos-Santos Â. Strategy to improve malaria surveillance system preventing transfusion-transmitted malaria in blood banks using molecular diagnostic. Malar J 2018; 17:344. [PMID: 30285750 PMCID: PMC6167815 DOI: 10.1186/s12936-018-2486-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Malaria can be transmitted by blood transfusion through donations collected from asymptomatic or parasitic donors. The parasites are released into the bloodstream during its life cycle and will therefore be present in donated blood by infected individuals. All cases of transfusion-transmitted malaria (TTM) notified since 2005 in Brazil were fatal. A good screening tool for Plasmodium spp. detection in blood units must have a high detection threshold, and the prevention of TTM relies entirely on the exclusion of potentially infected donors. However, in Brazilian blood banks, the screening test relies on blood thick smears examination. Methods The molecular diagnostic based on mitochondrial DNA (mtDNA) using real time PCR (mt-qPCR) was improved to detect Plasmodium falciparum, Plasmodium vivax, and standardized for use in Plasmodium malariae. The analytic sensitivity of this mt-qPCR methodology was performed using a sample of P. vivax. Results The mt-qPCR was highly efficient, and the analytic sensitivity for P. vivax was determined (0.000006 parasites/µL). This method was tested to detect P. vivax and P. falciparum in individuals from two malaria-endemic areas in Brazil, Amazon region (Pará and Rondônia states), the samples were collected in 10 reference units of two blood banks (Pará/nine cities and Rondônia/Porto Velho), and parasites mtDNA were detected in 10 of 2224 potential blood donors (0.45%). In all 10 positive samples, only P. vivax was detected. Conclusion Molecular diagnostic using mt-qPCR was effective in revealing infected potential donors with good perspectives to be applied as screening routine of asymptomatic carriers for preventing transfusion-transmitted malaria in blood banks.
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Affiliation(s)
- Sérgio Antônio Batista-Dos-Santos
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil.,Fundação Centro de Hemoterapia e Hematologia do Pará, Belém, Pará, CEP: 660033-000, Brazil
| | | | - Milene Raiol
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
| | - Gleyce F Cabral
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
| | - Ana Cecília Feio
- Instituto Evandro Chagas, Ananindeua, Pará, CEP: 66087-082, Brazil
| | - Marinete M Póvoa
- Instituto Evandro Chagas, Ananindeua, Pará, CEP: 66087-082, Brazil
| | - Maristela G Cunha
- Laboratório de Microbiologia e Imunologia, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil.
| | - Ândrea Ribeiro-Dos-Santos
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, CEP: 66075-110, Brazil
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28
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Calzetta M, Perugini E, Seixas G, Sousa CA, Guelbeogo WM, Sagnon N, Della Torre A, Pinto J, Pombi M, Mancini E. A novel nested polymerase chain reaction assay targeting Plasmodium mitochondrial DNA in field-collected Anopheles mosquitoes. MEDICAL AND VETERINARY ENTOMOLOGY 2018; 32:372-377. [PMID: 29344968 DOI: 10.1111/mve.12293] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 11/01/2017] [Accepted: 11/25/2017] [Indexed: 06/07/2023]
Abstract
Sensitive techniques for the detection of Plasmodium (Aconoidasida: Plasmodiidae) sporozoites in field-collected malaria vectors are essential for the correct assessment of risk for malaria transmission. A real-time polymerase chain reaction (RT-PCR) protocol targeting Plasmodium mtDNA proved to be much more sensitive in detecting sporozoites in mosquitoes than the widely used enzyme-linked immunosorbent assay targeting Plasmodium circumsporozoite protein (CSP-ELISA). However, because of the relatively high costs associated with equipment and reagents, RT-PCRs are mostly used to assess the outcomes of experimental infections in the frame of research experiments, rather than in routine monitoring of mosquito infection in the field. The present authors developed a novel mtDNA-based nested PCR protocol, modified from a loop-mediated isothermal amplification (LAMP) assay for Plasmodium recognition in human blood samples, and compared its performance with that of routinely used CSP-ELISAs in field-collected Anopheles coluzzii (Diptera: Culicidae) samples. The nested PCR showed 1.4-fold higher sensitivity than the CSP-ELISA. However, nested PCR results obtained in two laboratories and in different replicates within the same laboratory were not 100% consistent, probably because the copy number of amplifiable Plasmodium mtDNA was close in some specimens to the threshold of nested PCR sensitivity. This implies that Plasmodium-positive specimens should be confirmed by a second nested PCR to avoid false positives. Overall, the results emphasize the need to use molecular approaches to obtain accurate estimates of the actual level of Plasmodium circulation within malaria vector populations.
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Affiliation(s)
- M Calzetta
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - E Perugini
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
- Dipartimento di Scienze, Roma Tre University, Rome, Italy
| | - G Seixas
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - C A Sousa
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - W M Guelbeogo
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - N Sagnon
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - A Della Torre
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - J Pinto
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Pombi
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - E Mancini
- Dipartimento di Scienze, Roma Tre University, Rome, Italy
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29
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Gruenberg M, Moniz CA, Hofmann NE, Wampfler R, Koepfli C, Mueller I, Monteiro WM, Lacerda M, de Melo GC, Kuehn A, Siqueira AM, Felger I. Plasmodium vivax molecular diagnostics in community surveys: pitfalls and solutions. Malar J 2018; 17:55. [PMID: 29378609 PMCID: PMC5789620 DOI: 10.1186/s12936-018-2201-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/20/2018] [Indexed: 11/10/2022] Open
Abstract
A distinctive feature of Plasmodium vivax infections is the overall low parasite density in peripheral blood. Thus, identifying asymptomatic infected individuals in endemic communities requires diagnostic tests with high sensitivity. The detection limits of molecular diagnostic tests are primarily defined by the volume of blood analysed and by the copy number of the amplified molecular marker serving as the template for amplification. By using mitochondrial DNA as the multi-copy template, the detection limit can be improved more than tenfold, compared to standard 18S rRNA targets, thereby allowing detection of lower parasite densities. In a very low transmission area in Brazil, application of a mitochondrial DNA-based assay increased prevalence from 4.9 to 6.5%. The usefulness of molecular tests in malaria epidemiological studies is widely recognized, especially when precise prevalence rates are desired. Of concern, however, is the challenge of demonstrating test accuracy and quality control for samples with very low parasite densities. In this case, chance effects in template distribution around the detection limit constrain reproducibility. Rigorous assessment of false positive and false negative test results is, therefore, required to prevent over- or under-estimation of parasite prevalence in epidemiological studies or when monitoring interventions.
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Affiliation(s)
- Maria Gruenberg
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Clara Antunes Moniz
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Natalie Ellen Hofmann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Rahel Wampfler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Cristian Koepfli
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | | | - Marcus Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Universidade do Estado do Amazonas, Manaus, Brazil
| | - Gisely Cardoso de Melo
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Universidade do Estado do Amazonas, Manaus, Brazil
| | - Andrea Kuehn
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Andre M Siqueira
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Instituto Nacional de Infectologia, Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | - Ingrid Felger
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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30
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Loop-mediated isothermal DNA amplification for asymptomatic malaria detection in challenging field settings: Technical performance and pilot implementation in the Peruvian Amazon. PLoS One 2017; 12:e0185742. [PMID: 28982155 PMCID: PMC5628891 DOI: 10.1371/journal.pone.0185742] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/27/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Loop-mediated isothermal DNA amplification (LAMP) methodology offers an opportunity for point-of-care (POC) molecular detection of asymptomatic malaria infections. However, there is still little evidence on the feasibility of implementing this technique for population screenings in isolated field settings. METHODS Overall, we recruited 1167 individuals from terrestrial ('road') and hydric ('riverine') communities of the Peruvian Amazon for a cross-sectional survey to detect asymptomatic malaria infections. The technical performance of LAMP was evaluated in a subgroup of 503 samples, using real-time Polymerase Chain Reaction (qPCR) as reference standard. The operational feasibility of introducing LAMP testing in the mobile screening campaigns was assessed based on field-suitability parameters, along with a pilot POC-LAMP assay in a riverine community without laboratory infrastructure. RESULTS LAMP had a sensitivity of 91.8% (87.7-94.9) and specificity of 91.9% (87.8-95.0), and the overall accuracy was significantly better among samples collected during road screenings than riverine communities (p≤0.004). LAMP-based diagnostic strategy was successfully implemented within the field-team logistics and the POC-LAMP pilot in the riverine community allowed for a reduction in the turnaround time for case management, from 12-24 hours to less than 5 hours. Specimens with haemolytic appearance were regularly observed in riverine screenings and could help explaining the hindered performance/interpretation of the LAMP reaction in these communities. CONCLUSIONS LAMP-based molecular malaria diagnosis can be deployed outside of reference laboratories, providing similar performance as qPCR. However, scale-up in remote field settings such as riverine communities needs to consider a number of logistical challenges (e.g. environmental conditions, labour-intensiveness in large population screenings) that can influence its optimal implementation.
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31
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Mørch K, Manoharan A, Chandy S, Chacko N, Alvarez-Uria G, Patil S, Henry A, Nesaraj J, Kuriakose C, Singh A, Kurian S, Gill Haanshuus C, Langeland N, Blomberg B, Vasanthan Antony G, Mathai D. Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy. BMC Infect Dis 2017; 17:665. [PMID: 28978319 PMCID: PMC5628453 DOI: 10.1186/s12879-017-2764-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/25/2017] [Indexed: 01/04/2023] Open
Abstract
Background The objectives of this study were to determine the proportion of malaria, bacteraemia, scrub typhus, leptospirosis, chikungunya and dengue among hospitalized patients with acute undifferentiated fever in India, and to describe the performance of standard diagnostic methods. Methods During April 2011–November 2012, 1564 patients aged ≥5 years with febrile illness for 2–14 days were consecutively included in an observational study at seven community hospitals in six states in India. Malaria microscopy, blood culture, Dengue rapid NS1 antigen and IgM Combo test, Leptospira IgM ELISA, Scrub typhus IgM ELISA and Chikungunya IgM ELISA were routinely performed at the hospitals. Second line testing, Dengue IgM capture ELISA (MAC-ELISA), Scrub typhus immunofluorescence (IFA), Leptospira Microscopic Agglutination Test (MAT), malaria PCR and malaria immunochromatographic rapid diagnostic test (RDT) Parahit Total™ were performed at the coordinating centre. Convalescence samples were not available. Case definitions were as follows: Leptospirosis: Positive ELISA and positive MAT. Scrub typhus: Positive ELISA and positive IFA. Dengue: Positive RDT and/or positive MAC-ELISA. Chikungunya: Positive ELISA. Bacteraemia: Growth in blood culture excluding those defined as contaminants. Malaria: Positive genus-specific PCR. Results Malaria was diagnosed in 17% (268/1564) and among these 54% had P. falciparum. Dengue was diagnosed in 16% (244/1564). Bacteraemia was found in 8% (124/1564), and among these Salmonella typhi or S. paratyphi constituted 35%. Scrub typhus was diagnosed in 10%, leptospirosis in 7% and chikungunya in 6%. Fulfilling more than one case definition was common, most frequent in chikungunya where 26% (25/98) also had positive dengue test. Conclusions Malaria and dengue were the most common causes of fever in this study. A high overlap between case definitions probably reflects high prevalence of prior infections, cross reactivity and subclinical infections, rather than high prevalence of coinfections. Low accuracy of routine diagnostic tests should be taken into consideration when approaching the patient with acute undifferentiated fever in India.
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Affiliation(s)
- Kristine Mørch
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway. .,Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Anand Manoharan
- Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India
| | - Sara Chandy
- Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India
| | | | | | - Suvarna Patil
- B.K.L. Walawalkar Hospital, Ratnagiri, Maharashtra, India
| | - Anil Henry
- Christian Hospital, Mungeli, Chhattisgarh, India
| | | | - Cijoy Kuriakose
- Christian Fellowship Hospital, Oddanchatram, Tamil Nadu, India
| | - Ashita Singh
- Baptist Christian Hospital, Tezpur, Assam, India
| | - Siby Kurian
- Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India
| | - Christel Gill Haanshuus
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Nina Langeland
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - George Vasanthan Antony
- Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India
| | - Dilip Mathai
- Infectious Diseases Training and Research Centre, Department of Medicine, Christian Medical College, Vellore, India
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32
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Renoux LP, Dolan MC, Cook CA, Smit NJ, Sikkel PC. Developing an Apicomplexan DNA Barcoding System to Detect Blood Parasites of Small Coral Reef Fishes. J Parasitol 2017; 103:366-376. [PMID: 28395577 DOI: 10.1645/16-93] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Apicomplexan parasites are obligate parasites of many species of vertebrates. To date, there is very limited understanding of these parasites in the most-diverse group of vertebrates, actinopterygian fishes. While DNA barcoding targeting the eukaryotic 18S small subunit rRNA gene sequence has been useful in identifying apicomplexans in tetrapods, identification of apicomplexans infecting fishes has relied solely on morphological identification by microscopy. In this study, a DNA barcoding method was developed that targets the 18S rRNA gene primers for identifying apicomplexans parasitizing certain actinopterygian fishes. A lead primer set was selected showing no cross-reactivity to the overwhelming abundant host DNA and successfully confirmed 37 of the 41 (90.2%) microscopically verified parasitized fish blood samples analyzed in this study. Furthermore, this DNA barcoding method identified 4 additional samples that screened negative for parasitemia, suggesting this molecular method may provide improved sensitivity over morphological characterization by microscopy. In addition, this PCR screening method for fish apicomplexans, using Whatman FTA preserved DNA, was tested in efforts leading to a more simplified field collection, transport, and sample storage method as well as a streamlining sample processing important for DNA barcoding of large sample sets.
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Affiliation(s)
- Lance P Renoux
- Department of Biological Sciences, Room 202-Lab Science East, P.O. Box 599, State University, Arkansas 72467
| | - Maureen C Dolan
- Department of Biological Sciences, Room 202-Lab Science East, P.O. Box 599, State University, Arkansas 72467
| | | | | | - Paul C Sikkel
- Department of Biological Sciences, Room 202-Lab Science East, P.O. Box 599, State University, Arkansas 72467
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33
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Qurollo BA, Archer NR, Schreeg ME, Marr HS, Birkenheuer AJ, Haney KN, Thomas BS, Breitschwerdt EB. Improved molecular detection of Babesia infections in animals using a novel quantitative real-time PCR diagnostic assay targeting mitochondrial DNA. Parasit Vectors 2017; 10:128. [PMID: 28264705 PMCID: PMC5339974 DOI: 10.1186/s13071-017-2064-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Babesiosis is a protozoal, tick transmitted disease found worldwide in humans, wildlife and domesticated animals. Commonly used approaches to diagnose babesiosis include microscopic examination of peripheral blood smears, detection of circulating antibodies and PCR. To screen and differentiate canine Babesia infections many PCR assays amplify the 18S rRNA gene. These sequences contain hypervariable regions flanked by highly conserved regions allowing for amplification of a broad-range of Babesia spp. However, differences in the 18S rRNA gene sequence of distantly related clades can make it difficult to design assays that will amplify all Babesia species while excluding the amplification of other eukaryotes. By targeting Babesia mitochondrial genome (mtDNA), we designed a novel three primer qPCR with greater sensitivity and broader screening capabilities to diagnose and differentiate Babesia spp. METHODS Using 13 Babesia mtDNA sequences, a region spanning two large subunit rRNA gene fragments (lsu5-lsu4) was aligned to design three primers for use in a qPCR assay (LSU qPCR) capable of amplifying a wide range of Babesia spp. Plasmid clones were generated and used as standards to determine efficiency, linear dynamic range and analytical sensitivity. Animals naturally infected with vector-borne pathogens were tested retrospectively and prospectively to determine relative clinical sensitivity and specificity by comparing the LSU qPCR to an established 18S rDNA qPCR. RESULTS The LSU qPCR efficiencies ranged between 92 and 100% with the limit of detection at five copies/reaction. The assay did not amplify mammalian host or other vector-borne pathogen gDNA except Cytauxzoon felis (a feline protozoal pathogen). The LSU qPCR assay amplified 12 different Babesia. sp. and C. felis from 31/31 (100%) archived samples, whereas the 18S qPCR amplified only 26/31 (83.9%). By prospective analysis, 19/394 diagnostic accessions (4.8%) were LSU qPCR positive, compared to 11/394 (2.8%) 18S rDNA qPCR positive. CONCLUSIONS We have developed a more sensitive qPCR assay with a more expansive range of Babesia spp. detection by targeting a highly conserved region of mtDNA, when compared to an established 18S qPCR.
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Affiliation(s)
- Barbara A Qurollo
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
| | - Nikole R Archer
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Megan E Schreeg
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Henry S Marr
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Adam J Birkenheuer
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Kaitlin N Haney
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Brittany S Thomas
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Edward B Breitschwerdt
- Vector-borne Disease Diagnostic Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Haanshuus CG, Chandy S, Manoharan A, Vivek R, Mathai D, Xena D, Singh A, Langeland N, Blomberg B, Vasanthan G, Sitaram U, Appasamy J, Nesaraj J, Henry A, Patil S, Alvarez-Uria G, Armstrong L, Mørch K. A High Malaria Prevalence Identified by PCR among Patients with Acute Undifferentiated Fever in India. PLoS One 2016; 11:e0158816. [PMID: 27389396 PMCID: PMC4936667 DOI: 10.1371/journal.pone.0158816] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022] Open
Abstract
Background Approximately one million malaria cases were reported in India in 2015, based on microscopy. This study aims to assess the malaria prevalence among hospitalised fever patients in India identified by PCR, and to evaluate the performance of routine diagnostic methods. Methods During June 2011-December 2012, patients admitted with acute undifferentiated fever to seven secondary level community hospitals in Assam (Tezpur), Bihar (Raxaul), Chhattisgarh (Mungeli), Maharashtra (Ratnagiri), Andhra Pradesh (Anantapur) and Tamil Nadu (Oddanchatram and Ambur) were included. The malaria prevalence was assessed by polymerase chain reaction (PCR), routine microscopy, and a rapid diagnostic test (RDT) with PCR as a reference method. Results The malaria prevalence by PCR was 19% (268/1412) ranging from 6% (Oddanchatram, South India) to 35% (Ratnagiri, West India). Among malaria positive patients P. falciparum single infection was detected in 46%, while 38% had P. vivax, 11% mixed infections with P. falciparum and P. vivax, and 5% P. malariae. Compared to PCR, microscopy had sensitivity of 29% and specificity of 98%, while the RDT had sensitivity of 24% and specificity of 99%. Conclusions High malaria prevalence was identified by PCR in this cohort. Routine diagnostic methods had low sensitivity compared to PCR. The results suggest that malaria is underdiagnosed in rural India. However, low parasitaemia controlled by immunity may constitute a proportion of PCR positive cases, which calls for awareness of the fact that other pathogens could be responsible for the febrile disease in submicroscopic malaria.
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Affiliation(s)
- Christel Gill Haanshuus
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Sara Chandy
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Anand Manoharan
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
- * E-mail:
| | - Rosario Vivek
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Dilip Mathai
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Deepika Xena
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Ashita Singh
- Baptist Christian Hospital, Tezpur, Assam, India
| | - Nina Langeland
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - George Vasanthan
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | - Usha Sitaram
- Infectious Diseases Training and Research Center, Department of Medicine Unit-1 and Infectious Diseases, Christian Medical College, Vellore, India
| | | | | | - Anil Henry
- Christian Hospital, Mungeli, Chhattisgarh, India
| | - Suvarna Patil
- B.K.L. Walawalkar Hospital, Ratnagiri, Maharashtra, India
| | | | | | - Kristine Mørch
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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35
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Schreeg ME, Marr HS, Griffith EH, Tarigo JL, Bird DM, Reichard MV, Cohn LA, Levy MG, Birkenheuer AJ. PCR amplification of a multi-copy mitochondrial gene (cox3) improves detection of Cytauxzoon felis infection as compared to a ribosomal gene (18S). Vet Parasitol 2016; 225:123-30. [PMID: 27369587 DOI: 10.1016/j.vetpar.2016.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 11/19/2022]
Abstract
Cytauxzoon felis is a tick-transmitted protozoan parasite that infects felids. Clinical disease caused by acute C. felis infection rapidly progresses in domestic cats, leading to high morbidity and mortality. Accurately diagnosing cytauxzoonosis as soon as possible during acute infection would allow for earlier initiation of antiprotozoal therapy which could lead to higher survival rates. Molecular detection of parasite rRNA genes (18S) by PCR has previously been shown to be a sensitive method of diagnosing C. felis infections. Based on evidence from related apicomplexan species, we hypothesized that C. felis mitochondrial genes would exist at higher copy numbers than 18S and would be a more sensitive diagnostic target. In this study we have designed a PCR assay targeting the C. felis mitochondrial gene cytochrome c oxidase subunit III (cox3). Herein we demonstrate that (1) the cox3 PCR can detect as low as 1 copy of DNA target and can detect C. felis in samples with known mitochondrial sequence heterogeneity, (2) cox3 copy number is increased relative to 18S in blood and tissue samples from acutely infected cats, and (3) the cox3 PCR is more sensitive than 18S PCR for detection of C. felis during early infections.
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Affiliation(s)
- Megan E Schreeg
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Dr., Raleigh, NC 27607, United States
| | - Henry S Marr
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Dr., Raleigh, NC 27607, United States
| | - Emily H Griffith
- North Carolina State University, College of Sciences, Campus Box 8201/4216, Broughton Hall, Raleigh, NC 27695, United States
| | - Jaime L Tarigo
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Dr., Raleigh, NC 27607, United States
| | - David M Bird
- North Carolina State University, College of Agriculture and Life Sciences, 317A Ricks Hall 1, Lampe Dr., Raleigh, NC 27695, United States
| | - Mason V Reichard
- Oklahoma State University, Center for Veterinary Health Sciences, 205 McElroy Hall, Stillwater, OK 74078, United States
| | - Leah A Cohn
- University of Missouri, College of Veterinary Medicine, 900 E. Campus Dr., Columbia, MO, 65211, United States
| | - Michael G Levy
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Dr., Raleigh, NC 27607, United States
| | - Adam J Birkenheuer
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Dr., Raleigh, NC 27607, United States.
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Echeverry DF, Deason NA, Davidson J, Makuru V, Xiao H, Niedbalski J, Kern M, Russell TL, Burkot TR, Collins FH, Lobo NF. Human malaria diagnosis using a single-step direct-PCR based on the Plasmodium cytochrome oxidase III gene. Malar J 2016; 15:128. [PMID: 26928594 PMCID: PMC4772515 DOI: 10.1186/s12936-016-1185-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/20/2016] [Indexed: 01/29/2023] Open
Abstract
Background Nested PCRs based on the Plasmodium 18s-rRNA gene have been extensively used for human malaria diagnosis. However, they are not practical when large quantities of samples need to be processed, further there have been challenges in the performance and when interpreting results, especially when submicroscopic infections are analysed. Here the use of “direct PCR” was investigated with the aim of improving diagnosis in the malaria elimination era. Methods The performance of the Plasmodium cytochrome oxidase III gene (COX-III) based novel malaria detection strategies (direct nested PCR and direct single PCR) were compared using a 18s-rRNA direct nested PCR as a reference tool. Evaluations were based on sensitivity, specificity and the ability to detect mixed infections using control blood spot samples and field collected blood samples with final species diagnosis confirmation by sequencing. Results The COX-III direct PCR (limit of detection: 0.6–2 parasites/μL) was more sensitive than the 18s-rRNA direct nested PCR (limit of detection: 2–10 parasites/μL). The COX-III direct PCR identified all 21 positive controls (no mixed infections detected) while the 18s-rRNA direct nested PCR identified 18/21 (including four mixed infections). Different concentrations of simulated mixed infections (Plasmodium vivax and Plasmodium falciparum) suggest that the COX-III direct PCR detects only the predominant species. When the 18s-rRNA direct nested PCR was used to detect Plasmodium in field collected bloods spots (n = 3833), there was discrepancy in the results from the genus PCR (16 % positive) and the species-specific PCR (5 % positive). Further, a large portion of a subset of these positive samples (93 % for genus and 60 % for P. vivax), did not align with Plasmodium sequences. In contrast, the COX-III direct PCR clearly identified (single bands confirmed with sequencing) 2 % positive Plasmodium samples including P. vivax, P. falciparum, Plasmodium malariae and Plasmodium ovalewallikeri. Conclusions The COX-III single direct PCR is an alternative method for accurate detection of Plasmodium microscopic and submicroscopic infections in humans, especially when a large number of samples require screening. This PCR does not require DNA isolation, is sensitive, quick, produces confident/clear results, identifies all the Plasmodium species infecting humans, and is cost-effective.
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Affiliation(s)
- Diego F Echeverry
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Nicholas A Deason
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Jenna Davidson
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Victoria Makuru
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Honglin Xiao
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Julie Niedbalski
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Marcia Kern
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Tanya L Russell
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4870, Australia.
| | - Thomas R Burkot
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4870, Australia.
| | - Frank H Collins
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
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Gabrielli S, Bellina L, Milardi GL, Katende BK, Totino V, Fullin V, Cancrini G. Malaria in children of Tshimbulu (Western Kasai, Democratic Republic of the Congo): epidemiological data and accuracy of diagnostic assays applied in a limited resource setting. Malar J 2016; 15:81. [PMID: 26864461 PMCID: PMC4750168 DOI: 10.1186/s12936-016-1142-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/03/2016] [Indexed: 01/08/2023] Open
Abstract
Background The literature data on malaria in Western Kasai, DRC, are limited and inadequate. A recent molecular survey there has detected Plasmodium ovale and Plasmodium malariae as mixed infections with Plasmodium falciparum. In Tshimbulu, Western Kasai, during a humanitarian initiative designed to provide children with free preventive screening and to reduce the local high malaria death rate, accurate species identification was performed,
in order to collect unambiguous epidemiological data and to evaluate the reliability of locally applied diagnostics. Methods Finger pricks provided fresh blood for microscopic analysis (MA), for rapid diagnostic test (RDT) and for molecular diagnostics (MD). MA and RDT were first performed by the local team and then a re-interpretation of the results (on the same slides and on RDT’s taken pictures) was conducted in Italy, where MD were performed. Results The analysis was conducted on 306 children; RDT found 80.9 % as P. falciparum-positive (37.4 % as two-band positive, P. falciparum single infection). MA identified a further four children as positive to P. falciparum and six co-infections with P. ovale. The second RDT evaluation confirmed a similar infection rate (78.2 %) but interpreted as two-band positive a significantly higher share of tests (56.8 %). MA confirmed 80.0 % of the children as malaria positive and, in addition to P. falciparum, identified P. malariae (13.8 %), P. vivax (3.4 %) and P. ovale (2.4 %), and detected Babesia microti in 19 smears. MD confirmed all of the species found (Babesia microti included), classified as mono-infection with P. falciparum a rate of spots comparable to MA revision, and identified all P. ovale as Plasmodium ovale wallikeri. The RDT used locally proved 93.1 % sensitive and 92.1 % specific for P. falciparum. Conclusions The malaria prevalence among the children and the presence of four Plasmodium species, highlighted in this study, identified a sanitary issue which proved to be more alarming than expected, as it was worsened by the unpredictable presence of P. vivax and Babesia microti (never before reported in DRC). Each diagnostic tool showed its point of weakness. Therefore, the most correct approach is by the combined use of different, locally available, diagnostic tools.
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Affiliation(s)
- Simona Gabrielli
- Dip. Sanità Pubblica e Malattie infettive, Università "Sapienza", P.le Aldo Moro 5, 00185, Rome, Italy.
| | - Livia Bellina
- MobileDiagnosis Onlus, via Sciuti 180, 90144, Palermo, Italy.
| | - Giovanni Luigi Milardi
- Dip. Sanità Pubblica e Malattie infettive, Università "Sapienza", P.le Aldo Moro 5, 00185, Rome, Italy.
| | | | - Valentina Totino
- Dip. Sanità Pubblica e Malattie infettive, Università "Sapienza", P.le Aldo Moro 5, 00185, Rome, Italy.
| | - Valerio Fullin
- St François Hospital, Tshimbulu, BP 185, Kananga, Western Kasai, Democratic Republic of Congo.
| | - Gabriella Cancrini
- Dip. Sanità Pubblica e Malattie infettive, Università "Sapienza", P.le Aldo Moro 5, 00185, Rome, Italy.
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Molecular Approaches for Diagnosis of Malaria and the Characterization of Genetic Markers for Drug Resistance. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chua KH, Lim SC, Ng CC, Lee PC, Lim YAL, Lau TP, Chai HC. Development of High Resolution Melting Analysis for the Diagnosis of Human Malaria. Sci Rep 2015; 5:15671. [PMID: 26507008 PMCID: PMC4623528 DOI: 10.1038/srep15671] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/23/2015] [Indexed: 11/18/2022] Open
Abstract
Molecular detection has overcome limitations of microscopic examination by providing greater sensitivity and specificity in Plasmodium species detection. The objective of the present study was to develop a quantitative real-time polymerase chain reaction coupled with high-resolution melting (qRT-PCR-HRM) assay for rapid, accurate and simultaneous detection of all five human Plasmodium spp. A pair of primers targeted the 18S SSU rRNA gene of the Plasmodium spp. was designed for qRT-PCR-HRM assay development. Analytical sensitivity and specificity of the assay were evaluated. Samples collected from 229 malaria suspected patients recruited from Sabah, Malaysia were screened using the assay and results were compared with data obtained using PlasmoNex(TM), a hexaplex PCR system. The qRT-PCR-HRM assay was able to detect and discriminate the five Plasmodium spp. with lowest detection limits of 1-100 copy numbers without nonspecific amplifications. The detection of Plasmodium spp. in clinical samples using this assay also achieved 100% concordance with that obtained using PlasmoNex(TM). This indicated that the diagnostic sensitivity and specificity of this assay in Plasmodium spp. detection is comparable with those of PlasmoNex(TM). The qRT-PCR-HRM assay is simple, produces results in two hours and enables high-throughput screening. Thus, it is an alternative method for rapid and accurate malaria diagnosis.
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Affiliation(s)
- Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Siew Chee Lim
- Institutue of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ching Ching Ng
- Institutue of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ping Chin Lee
- School of Science and Technology, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Tze Pheng Lau
- Department of Pathology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hwa Chia Chai
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Oriero EC, Van Geertruyden JP, Nwakanma DC, D'Alessandro U, Jacobs J. Novel techniques and future directions in molecular diagnosis of malaria in resource-limited settings. Expert Rev Mol Diagn 2015; 15:1419-26. [PMID: 26413727 DOI: 10.1586/14737159.2015.1090878] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Despite being preventable and treatable, malaria remains a global health concern with approximately 1.2 billion people at high risk of being infected, 90% of whom are in the resource-limited settings of sub-Saharan Africa. The continued decline in malaria cases globally has rekindled the possibility of elimination in certain regions. As humans constitute the main reservoir of malaria, prompt and accurate diagnosis by microscopy or rapid diagnostic tests is part not only of effective disease management but also of control measures. However, for malaria elimination, more sensitive diagnostic tools are needed to detect asymptomatic and sub-microscopic infections that contribute to transmission. Molecular techniques, which involve amplification of nucleic acids, are being developed and modified to suit this purpose. This report provides a summary of the nucleic acid amplification tests that are currently available for diagnosis of malaria, with current improvements and adaptations for use in resource-limited settings.
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Affiliation(s)
- Eniyou Cheryll Oriero
- a 1 Medical Research Council Unit , Fajara, The Gambia.,b 2 International Health Unit, University of Antwerp , Antwerp, Belgium.,c 3 Institute of Tropical Medicine , Antwerp, Belgium
| | | | | | - Umberto D'Alessandro
- a 1 Medical Research Council Unit , Fajara, The Gambia.,c 3 Institute of Tropical Medicine , Antwerp, Belgium.,d 4 London School of Tropical Medicine and Hygiene , London, UK
| | - Jan Jacobs
- c 3 Institute of Tropical Medicine , Antwerp, Belgium.,e 5 Department of Microbiology and Immunology, University of Leuven , Leuven, Belgium
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Pattaradilokrat S, Tiyamanee W, Simpalipan P, Kaewthamasorn M, Saiwichai T, Li J, Harnyuttanakorn P. Molecular detection of the avian malaria parasite Plasmodium gallinaceum in Thailand. Vet Parasitol 2015; 210:1-9. [DOI: 10.1016/j.vetpar.2015.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 03/17/2015] [Accepted: 03/23/2015] [Indexed: 01/21/2023]
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Oriero CE, van Geertruyden JP, Jacobs J, D'Alessandro U, Nwakanma D. Validation of an apicoplast genome target for the detection of Plasmodium species using polymerase chain reaction and loop mediated isothermal amplification. Clin Microbiol Infect 2015; 21:686.e1-7. [PMID: 25747504 DOI: 10.1016/j.cmi.2015.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/18/2015] [Accepted: 02/24/2015] [Indexed: 11/30/2022]
Abstract
The genome of the Plasmodium apicoplast, which has a higher copy number compared with current targets for molecular diagnosis of malaria, appears to be a suitable target for detection of submicroscopic infections that are capable of sustaining transmission. Novel primers targeting a conserved segment of the apicoplast (PFC10_AP|0010:rRNA) were designed and used in a number of different high throughput platforms such as single-step PCR (ssPCR), nested PCR (nPCR) and loop-mediated isothermal amplification (LAMP) for parasite detection. Replicates of ten-fold serial dilutions of Plasmodium falciparum 3D7 DNA, with equivalent parasite density ranges of 200,000 to 0.2 parasites/μL, were used to determine the limit of detection and repeatability of each assay. A panel of 184 archived DNA samples extracted from either EDTA whole blood or dried blood spots, from across West Africa and South East Asia was used to determine the diagnostic performance of the assays. All assays amplified the 2 parasites/μL dilution except the ssPCR, which amplified two of the three replicates. Using an 18S rRNA PCR as reference, the sensitivity was 98% (95% CI 93-100%) for the LAMP assay, 87% (95% CI 79-93%) for ssPCR and 100% (95% CI 97-100%) for nPCR. Specificity was 91% (95% CI 83-96%) for LAMP, 82% (95% CI 72-90%) for ssPCR and 66% (95% CI 54-76%) for nPCR. The apicoplast genome-based nPCR detected more positive samples overall than the reference method. Discrepant samples were confirmed as true positives using a probe-based real-time quantitative PCR assay. The results show that the apicoplast genome is a suitable target for molecular diagnosis of malaria.
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Affiliation(s)
- C E Oriero
- Medical Research Council, Fajara, Gambia; International Health Unit, University of Antwerp, Belgium; Institute of Tropical Medicine, Antwerp, Belgium.
| | | | - J Jacobs
- Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Belgium
| | - U D'Alessandro
- Medical Research Council, Fajara, Gambia; Institute of Tropical Medicine, Antwerp, Belgium; London School of Tropical Medicine and Hygiene, London, UK
| | - D Nwakanma
- Medical Research Council, Fajara, Gambia
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Hofmann N, Mwingira F, Shekalaghe S, Robinson LJ, Mueller I, Felger I. Ultra-sensitive detection of Plasmodium falciparum by amplification of multi-copy subtelomeric targets. PLoS Med 2015; 12:e1001788. [PMID: 25734259 PMCID: PMC4348198 DOI: 10.1371/journal.pmed.1001788] [Citation(s) in RCA: 232] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 01/08/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Planning and evaluating malaria control strategies relies on accurate definition of parasite prevalence in the population. A large proportion of asymptomatic parasite infections can only be identified by surveillance with molecular methods, yet these infections also contribute to onward transmission to mosquitoes. The sensitivity of molecular detection by PCR is limited by the abundance of the target sequence in a DNA sample; thus, detection becomes imperfect at low densities. We aimed to increase PCR diagnostic sensitivity by targeting multi-copy genomic sequences for reliable detection of low-density infections, and investigated the impact of these PCR assays on community prevalence data. METHODS AND FINDINGS Two quantitative PCR (qPCR) assays were developed for ultra-sensitive detection of Plasmodium falciparum, targeting the high-copy telomere-associated repetitive element 2 (TARE-2, ∼250 copies/genome) and the var gene acidic terminal sequence (varATS, 59 copies/genome). Our assays reached a limit of detection of 0.03 to 0.15 parasites/μl blood and were 10× more sensitive than standard 18S rRNA qPCR. In a population cross-sectional study in Tanzania, 295/498 samples tested positive using ultra-sensitive assays. Light microscopy missed 169 infections (57%). 18S rRNA qPCR failed to identify 48 infections (16%), of which 40% carried gametocytes detected by pfs25 quantitative reverse-transcription PCR. To judge the suitability of the TARE-2 and varATS assays for high-throughput screens, their performance was tested on sample pools. Both ultra-sensitive assays correctly detected all pools containing one low-density P. falciparum-positive sample, which went undetected by 18S rRNA qPCR, among nine negatives. TARE-2 and varATS qPCRs improve estimates of prevalence rates, yet other infections might still remain undetected when absent in the limited blood volume sampled. CONCLUSIONS Measured malaria prevalence in communities is largely determined by the sensitivity of the diagnostic tool used. Even when applying standard molecular diagnostics, prevalence in our study population was underestimated by 8% compared to the new assays. Our findings highlight the need for highly sensitive tools such as TARE-2 and varATS qPCR in community surveillance and for monitoring interventions to better describe malaria epidemiology and inform malaria elimination efforts.
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Affiliation(s)
- Natalie Hofmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Felista Mwingira
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Biological Sciences Department, Dar es Salaam University College of Education, Dar es Salaam, Tanzania
| | | | - Leanne J. Robinson
- Papua New Guinea Institute of Medical Research, Madang and Maprik, Papua New Guinea
- Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
- Centre de Recerca en Salut Internacional de Barcelona, Barcelona, Spain
| | - Ingrid Felger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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The design and evaluation of a shaped filter collection device to sample and store defined volume dried blood spots from finger pricks. Malar J 2015; 14:45. [PMID: 25652763 PMCID: PMC4327959 DOI: 10.1186/s12936-015-0558-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dried blood spots are a common medium for collecting patient blood prior to testing for malaria by molecular methods. A new shaped filter device for the quick and simple collection of a designated volume of patient blood has been designed and tested against conventional blood spots for accuracy and precision. METHODS Shaped filter devices were laser cut from Whatman GB003 paper to absorb a 20 μl blood volume. These devices were used to sample Plasmodium falciparum infected blood and the volume absorbed was measured volumetrically. Conventional blood spots were made by pipetting 20 μl of the same blood onto Whatman 3MM paper. DNA was extracted from both types of dried blood spot using Qiagen DNA blood mini or Chelex extraction for real-time PCR analysis, and PURE extraction for malaria LAMP testing. RESULTS The shaped filter devices collected a mean volume of 21.1 μl of blood, with a coefficient of variance of 8.1%. When used for DNA extraction by Chelex and Qiagen methodologies the mean number of international standard units of P. falciparum DNA recovered per μl of the eluate was 53.1 (95% CI: 49.4 to 56.7) and 32.7 (95% CI: 28.8 to 36.6), respectively for the shaped filter device, and 54.6 (95% CI: 52.1 to 57.1) and 12.0 (95% CI: 9.9 to 14.1), respectively for the 3MM blood spots. Qiagen extraction of 200 μl of whole infected blood yielded 853.6 international standard units of P. falciparum DNA per μl of eluate. CONCLUSIONS A shaped filter device provides a simple way to quickly sample and store a defined volume of blood without the need for any additional measuring devices. Resultant dried blood spots may be employed for DNA extraction using a variety of technologies for nucleic acid amplification without the need for repeated cleaning of scissors or punches to prevent cross contamination of samples and results are comparable to traditional DBS.
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Isozumi R, Fukui M, Kaneko A, Chan CW, Kawamoto F, Kimura M. Improved detection of malaria cases in island settings of Vanuatu and Kenya by PCR that targets the Plasmodium mitochondrial cytochrome c oxidase III (cox3) gene. Parasitol Int 2014; 64:304-8. [PMID: 25256904 DOI: 10.1016/j.parint.2014.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 07/25/2014] [Accepted: 09/12/2014] [Indexed: 11/25/2022]
Abstract
Detection of sub-microscopic parasitemia is crucial for all malaria elimination programs. PCR-based methods have proven to be sensitive, but two rounds of amplification (nested PCR) are often needed to detect the presence of Plasmodium DNA. To simplify the detection process, we designed a nested PCR method whereby only the primary PCR is required for the detection of the four major human Plasmodium species. Primers designed for the detection of the fifth species, Plasmodium knowlesi, were not included in this study due to the absence of appropriate field samples. Compared to the standard 18S rDNA PCR method, our cytochrome c oxidase III (cox3) method detected 10-50% more cases while maintaining high sensitivities (1.00) for all four Plasmodium species in our samples from Vanuatu (n=77) and Kenya (n=76). Improvement in detection efficiency was more substantial for samples with sub-microscopic parasitemia (54%) than those with observable parasitemia (10-16%). Our method will contribute to improved malaria surveillance in low endemicity settings.
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Affiliation(s)
- Rie Isozumi
- Department of Medical Zoology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Mayumi Fukui
- Department of Medical Zoology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Akira Kaneko
- Department of Medical Zoology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan; Island Malaria Group, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Nobels väg 16, SE 171 77 Stockholm, Sweden
| | - Chim W Chan
- Island Malaria Group, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Nobels väg 16, SE 171 77 Stockholm, Sweden
| | - Fumihiko Kawamoto
- Division of International Health, Research Promotion Project, Oita University Faculty of Medicine, Yufu 879-5593, Japan
| | - Masatsugu Kimura
- Radioisotope Centre, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
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Kim JY, Goo YK, Ji SY, Shin HI, Han ET, Hong Y, Chung DI, Cho SH, Lee WJ. Development and efficacy of real-time PCR in the diagnosis of vivax malaria using field samples in the Republic of Korea. PLoS One 2014; 9:e105871. [PMID: 25148038 PMCID: PMC4141806 DOI: 10.1371/journal.pone.0105871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 07/25/2014] [Indexed: 11/18/2022] Open
Abstract
The development of sensitive, rapid, and accurate diagnostic methods for vivax malaria is essential for the effective control of malaria in the Republic of Korea, where vivax malaria patients usually show low parasitemia. In this study, a TaqMan-based real-time polymerase chain reaction (PCR) method was established and compared with other PCR-based assays, including nested PCR, loop-mediated isothermal amplification, and multiplex PCR, using samples from febrile patients with suspected vivax malaria. The established real-time PCR had a high sensitivity (99.6%) and specificity (100%). Therefore, this sensitive, specific, rapid, and quantitative real-time PCR method could be used for the routine diagnosis of vivax malaria in the laboratory of the Korea National Institute of Health.
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Affiliation(s)
- Jung-Yeon Kim
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
| | - Youn-Kyoung Goo
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - So-Young Ji
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
| | - Hyun-Il Shin
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
| | - Eun-Taek Han
- Department of Parasitology, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Yeonchul Hong
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Dong-Il Chung
- Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Shin-Hyung Cho
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
| | - Won-Ja Lee
- Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea
- * E-mail:
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Performance of coumarin-derived dendrimer-based fluorescence-linked immunosorbent assay (FLISA) to detect malaria antigen. Malar J 2014; 13:266. [PMID: 25011624 PMCID: PMC4105783 DOI: 10.1186/1475-2875-13-266] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/04/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to limitation of conventional malaria diagnostics, including microscopy, polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA), alternative accurate diagnostics have been demanded for improvement of sensitivity and specificity. METHODS Serially diluted Plasmodium LDH antigens, Plasmodium falciparum-infected human red blood cells (RBC) derived from in vitro culture or patient's samples were used for evaluation of the performance of fluorescence-linked immunosorbent assay (FLISA). Microscopic examination was used to determine parasite density and the performance of FLISA was compared to ELISA. Finally, sensitivity and specificity of FLISA was determined by human specimens infected with P. falciparum, Plasmodium vivax, Toxoplasma gondii, and amoebae. RESULTS As a result of FLISA, the fluorescent intensity was highly correlated with antigen amount and FLISA was more sensitive than ELISA. FLISA detected at least 0.01 ng/ml of pLDH antigen, which showed 1,000-fold higher sensitivity than ELISA. In vitro-cultured P. falciparum was detected up to 20 parasite number/μL in FLISA but 5120 parasite number/μLin sandwich ELISA. In vitro P. falciparum-infected RBC number was highly correlated with fluorescent intensity (R2 = 0.979), showing that FLISA was reliable for detection of P. falciparum and available for quantification of parasite numbers. Furthermore, eighteen patient samples infected with P. falciparum (n = 9) and P. vivax (n = 9) showed 100% of sensitivity (18/18). FLISA showed 96.3% of specificity (26/27) because one sample of patient blood infected with T. gondii gave a false positive reactivity among healthy donors (n = 9), T. gondii-infected patients (n = 9), and amoeba-infected patients (n = 9). CONCLUSION FLISA has a keen and high performance to detect malaria antigen, suggesting a potential assay as malaria immunodiagnostic.
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Strøm GEA, Tellevik MG, Hanevik K, Langeland N, Blomberg B. Comparison of four methods for extracting DNA from dried blood on filter paper for PCR targeting the mitochondrial Plasmodium genome. Trans R Soc Trop Med Hyg 2014; 108:488-94. [PMID: 24907711 PMCID: PMC4096016 DOI: 10.1093/trstmh/tru084] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Few studies comparing multiple methods for DNA extraction from dried blood spots (DBS) on filter paper for PCR targeting the Plasmodium genome have been done. METHODS Frequently-used methods for DNA extraction from DBS using Chelex-100, InstaGene Matrix, QIAamp DNA Mini Kit and TE buffer were compared on a dilution series of a standardized Plasmodium falciparum positive sample. The two DNA extraction methods resulting in the lowest limits of detection were compared by testing both on 31 P. falciparum positive samples collected under field conditions and stored for 4 years. RESULTS The Chelex-100, InstaGene Matrix and QIAamp DNA Mini Kit methods performed similarly, resulting in the detection of 0.5 to 2 parasites per microliter (p/µl). The same 13 clinical samples (13/31; 42%) were positive using both DNA extraction methods with the lowest limits of detection. CONCLUSIONS Simple and low-cost methods can be sensitive and useful in extracting DNA from DBS. Poor results on stored clinical DBS indicate that further studies on the impact of storage duration and conditions, and choice of filter paper should be performed.
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Affiliation(s)
- Gro E A Strøm
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Marit G Tellevik
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Kurt Hanevik
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
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Comparison of three PCR-based assays for the non-invasive diagnosis of malaria: detection of Plasmodium parasites in blood and saliva. Eur J Clin Microbiol Infect Dis 2014; 33:1631-9. [PMID: 24792127 DOI: 10.1007/s10096-014-2121-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
The conventional molecular diagnosis of malaria uses 18S rRNA-based PCR assay employing blood samples. This assay presents limitation in terms of long turnaround time and increased chances of false-positive results. Here, we evaluated one-step singleplex or multiplex PCR assay based on high copy species-specific consensus repeat sequences (CRS) along with standard 18S rRNA nested PCR (18S n-PCR) assay to detect P. falciparum and P. vivax infection using blood and saliva samples from Indian febrile patients. Out of 327 patients, 187 were found to be positive for malaria parasites by microscopic examination of peripheral blood smears. Among these 130 were P. vivax and 57 were P. falciparum cases. The 18S n-PCR assay and CRS PCR assay identified 186 out of 187 cases (99.4 %). Multiplex CRS PCR assay detected Plasmodium in 176 out of 187 cases (94.1 %). Both singleplex and multiplex CRS PCR assay identified 6 mixed infection cases, while 18S n-PCR assay detected 10 mixed infection cases of P. vivax and P. falciparum, which were not recognized by microscopy. Non-invasive Plasmodium detection rate with DNA derived from saliva samples was highest for 18S n-PCR (87.36 %), followed by singleplex CRS (81 %) and multiplex CRS PCR assay (70.5 %). Specificity for P. vivax and P. falciparum detection for all assays was 98.48 % and 100 % respectively. Detection rate for P. vivax in saliva correlated with parasite density for CRS target-based assays. The species-specific CRS PCR, either as a singleplex or multiplex assay, can have an impact on diagnosis and epidemiological studies in malaria.
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Strøm GEA, Moyo S, Fataki M, Langeland N, Blomberg B. PCR targeting Plasmodium mitochondrial genome of DNA extracted from dried blood on filter paper compared to whole blood. Malar J 2014; 13:137. [PMID: 24708551 PMCID: PMC3983671 DOI: 10.1186/1475-2875-13-137] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/02/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Monitoring mortality and morbidity attributable to malaria is paramount to achieve elimination of malaria. Diagnosis of malaria is challenging and PCR is a reliable method for identifying malaria with high sensitivity. However, blood specimen collection and transport can be challenging and obtaining dried blood spots (DBS) on filter paper by finger-prick may have advantages over collecting whole blood by venepuncture. METHODS DBS and whole blood were collected from febrile children admitted at the general paediatric wards at a referral hospital in Dar es Salaam, Tanzania. DNA extracted from whole blood and from DBS was tested with a genus-specific PCR targeting the mitochondrial Plasmodium genome. Positive samples by PCR of DNA from whole blood were tested with species-specific PCR targeting the 18S rRNA locus, or sequencing if species-specific PCR was negative. Rapid diagnostic test (RDT) and thin blood smear microscopy was carried out on all patients where remnant whole blood and a blood slide, respectively, were available. RESULTS Positivity of PCR was 24.5 (78/319) and 11.2% (52/442) by whole blood and DBS, respectively. All samples positive on DBS were also positive on Plasmodium falciparum species-specific PCR. All RDT positive cases were also positive by DBS PCR. All but three cases with positive blood slides were also positive by DBS. CONCLUSIONS In this study, PCR for malaria mitochondrial DNA extracted from whole blood was more sensitive than from DBS. However, DBS are a practical alternative to whole blood and detected approximately the same number of cases as RDTs and, therefore, remain relevant for research purposes.
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Affiliation(s)
- Gro E A Strøm
- Department of Clinical Science, University of Bergen, Bergen, Norway.
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