Short Report: Prevalence of PCR Detectable Malaria Infection among Febrile Patients with a Negative Plasmodium falciparum Specific Rapid Diagnostic Test in Zanzibar
Short Report: Prevalence of PCR Detectable Malaria Infection among Febrile Patients with a Negative Plasmodium falciparum Specific Rapid Diagnostic Test in Zanzibar
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DOI：
10.4269/ajtmh.2012.12-0095
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发表时间：
2013-02-01
影响因子：
3.3
通讯作者：
Greenhouse, Bryan
中科院分区：
文献类型：
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作者：
Baltzell, Kimberly A.;Shakely, Deter;Greenhouse, Bryan
2010年5月至8月，我们在桑给巴尔北A区和Micheweni区的12个卫生机构对594份发热患者的血液样本进行了疟疾筛查，这些患者通过基于恶性疟原虫特异性富组氨酸蛋白-2的快速诊断试验检测为阴性。筛查采用显微镜、针对四种主要人类疟疾物种的细胞色素B基因的聚合酶链反应（PCR）和定量PCR（qPCR）。cytbPCR可检测的疟疾感染的患病率为2%（12/594），包括8例恶性疟原虫、3例三日疟原虫和1例间日疟原虫感染。显微镜检查确定了8例恶性疟原虫感染中的4例。在8例cytbPCR可检测的恶性疟原虫感染中，5例通过显微镜或qPCR估计的寄生虫密度> 4，000个寄生虫/μ L。快速诊断检测试剂漏掉的感染是消除疟疾环境中的一个特殊挑战，突出表明需要更敏感的护理点诊断工具，以改善发热患者中所有人类疟疾物种的病例检测。
We screened for malaria in 594 blood samples from febrile patients who tested negative by a Plasmodium falciparum-specific histidine-rich protein-2-based rapid diagnostic test at 12 health facilities in Zanzibar districts North A and Micheweni, from May to August 2010. Screening was with microscopy, polymerase chain reaction (PCR) targeting the cytochrome b gene (cytbPCR) of the four major human malaria species, and quantitative PCR (qPCR). The prevalence of cytbPCR-detectable malaria infection was 2% (12 of 594), including 8 P. falciparum, 3 Plasmodium malariae, and 1 Plasmodium vivax infections. Microscopy identified 4 of 8 P. falciparum infections. Parasite density as estimated by microscopy or qPCR was > 4,000 parasites/mu L in 5 of 8 cytbPCR-detectable P. falciparum infections. The infections that were missed by the rapid diagnostic test represent a particular challenge in malaria elimination settings and highlight the need for more sensitive point-of-care diagnostic tools to improve case detection of all human malaria species in febrile patients.