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Prevalencia de Malaria definida mediante microscopia, detección de antígenos, amplificación del ADN y amplificación de ácidos nucleicos totales en una región endémica para malaria durante el pico de la estación de transmisión de malaria
Author(s) -
Waitumbi John N.,
Gerlach Jay,
Afonina Irina,
Anyona Samuel B.,
Koros Joseph N.,
Siangla Joram,
Ankoudinova Irina,
Singhal Mitra,
Watts Kate,
Polhemus Mark E.,
Vermeulen Nicolaas M.,
Mahoney Walt,
Steele Matt,
Domingo Gonzalo J.
Publication year - 2011
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2011.02773.x
Subject(s) - malaria , virology , biology , immunology
Summary Objectives To determine the malaria prevalence by microscopy, antigen detection and nucleic acid detection in a defined subpopulation in a Plasmodium falciparum– endemic region during the peak transmission season. Methods Blood specimens were collected in a cross‐sectional study involving children aged 5–10 years ( n = 195) presenting with acute fever to two clinics in Western Kenya. All specimens underwent microscopy, HRP2 and aldolase antigen detection by enzyme immunoassay (EIA), parasite‐specific DNA and total nucleic acid (RNA and DNA) by real‐time PCR (qPCR) and reverse‐transcriptase PCR (qRT‐PCR). Results Microscopy detected 65/195 cases of malaria infection [95% confidence interval (CI) 52–78]. HRP2 and aldolase EIA had similar sensitivity levels detecting antigen in 65/195 (95% CI, 52–78) and 57/195 (95% CI, 45–70) cases. Discordants in antigen detection vs. microscopy occurred at <470 parasites/μl and <4900 parasites/μl for HRP2 and aldolase, respectively. Detection of total nucleic acid allowed a 3 log lower limit of detection than just DNA detection by real‐time PCR in vitro . In clinical specimens, 114/195 (95% CI, 100–127) were qPCR positive (DNA), and 187/195 (95% CI, 179–191) were qRT‐PCR positive (DNA plus RNA). Conclusions The prevalence of submicroscopic malaria infection was significantly higher when detecting total nucleic acid than just DNA in this outpatient population during the high transmission season. Defining standards for submicroscopic infection will be important for control programmes, diagnostics development efforts and molecular epidemiology studies.