Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011-2018
Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011-2018
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华中地区武汉市非洲和亚洲输入性疟疾分子流行病学监测：2011-2018年诊断工具比较
DOI：
10.1186/s12936-020-03387-2
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发表时间：
2020-09-03
期刊：
影响因子：
3
通讯作者：
Li, Jian
中科院分区：
文献类型：
--
作者：
Xie, Yiting;Wu, Kai;Li, Jian
背景疟疾是一个严重的全球性公共卫生问题。随着中国消灭本土疟疾工作的继续进行，输入性疟疾逐渐成为一个重大的健康危害。及时准确的诊断可以支持及时实施治疗计划，揭示输入性疟疾的流行情况，避免疾病的传播。所有患者均接受显微镜和快速诊断试验（RDT）检查。对阳性或疑似阳性病例分别采用18SrRNA巢式PCR和Taqman探针实时荧光PCR检测4种人感染性疟原虫。对两种分子诊断方法的结果进行了分析。结果共收集296份血样，其中镜检和RDT阳性288份，RDT和恶性疟原虫阳性7份，疑似病例1份。应用这两种分子生物学方法并测序后，291例包括245P。恶性疟15例，间日疟15例，卵形疟20例，疟疾6例，混合感染5例（3 P.恶性疟原虫+卵圆线虫，2株P.间日疟原虫+卵形疟原虫）。这些患者从非洲（95.53%）和亚洲（4.47%）返回。虽然发病率呈小范围波动，但输入病例的总体趋势是逐年上升的。结论这些结果强调了在包括武汉在内的全球潜在风险地区的临床和实地调查中联合使用四种疟疾诊断工具的必要性。
BackgroundMalaria remains a serious public health problem globally. As the elimination of indigenous malaria continues in China, imported malaria has gradually become a major health hazard. Well-timed and accurate diagnoses could support the timely implementation of therapeutic schedules, reveal the prevalence of imported malaria and avoid transmission of the disease.MethodsBlood samples were collected in Wuhan, China, from August 2011 to December 2018. All patients accepted microscopy and rapid diagnosis test (RDT) examinations. Subsequently, each of the positive or suspected positive cases was tested for four human-infectiousPlasmodiumspecies by using 18S rRNA-based nested PCR and Taqman probe-based real-time PCR. The results of the microscopy and the two molecular diagnostic methods were analysed. Importation origins were traced by country, and the prevalence ofPlasmodiumspecies was analysed by year.ResultsA total of 296 blood samples, including 288 that were microscopy and RDT positive, 7 RDT andPlasmodium falciparumpositive, and 1 suspected case, were collected and reanalysed. After application of the two molecular methods and sequencing, 291 cases including 245P. falciparum, 15Plasmodium vivax, 20Plasmodium ovale, 6Plasmodium malariaeand 5 mixed infections (3P. falciparum+P. ovale, 2P. vivax+P. ovale) were confirmed. These patients had returned from Africa (95.53%) and Asia (4.47%). Although the prevalence displayed a small-scale fluctuation, the overall trend of the imported cases increased yearly.ConclusionsThese results emphasize the necessity of combined utilization of the four tools for malaria diagnosis in clinic and in field surveys of potential risk regions worldwide including Wuhan.