Concordance between thick blood smear, immunochromatography and polymerase chain reaction for malaria diagnosis
Keywords:
Plasmodium, malaria/diagnosis, diagnostic techniques and procedures, predictive value of tests, sensitivity and specificity, polymerase chain reaction
Abstract
Introduction. The rapid and effective diagnosis of malaria is the determining condition for an appropriate treatment and control of the disease.Objective. The sensitivity, specificity and the positive and negative predictive values were evaluated in cases of suspected malaria in Colombia in a comparison of a rapid diagnostic test. the PCR test and the thick blood smear-the traditional gold standard.
Materials and methods. A group of 100 patients with symptoms compatible with malaria, were included in the study. They were selected from the following Colombian regions: Urabá, Córdoba, lower Cauca, and relatively fewer from other malaria endemic areas of Colombia including the provinces of Valle, Chocó in the central west of Colombia and Vichada to the east. To each patient the following three tests were performed: the rapid OptiMAL® test, the PCR identification and the thick blood smear. The PCR amplified specific DNA sequences with primers designed to identify the genus Plasmodium, and the two species present in Colombia, P. falciparum and P. vivax.
Results. The sensitivity of the rapid test versus the thick smear, for the diagnosis of both species of Plasmodium was 93.9% (95% CI: 87-100%) and the specificity was 94.3% (95% CI:.253 85-100%). The PCR compared with the thick smear showed a sensitivity of 100% (95% CI: 99-100%) and a specificity of 97.1% (95% CI: 90-100%).
Conclusions. The sensitivity and specificity of the three tests did not present statistically significant differences. However, the thick blood smear was recommended as the standard test, mainly due to its low cost.
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References
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18. Iqbal J, Muneer A, Khalid N, Ahmed MA. Performance of the OptiMAL test for malaria diagnosis among suspected malaria patients at the rural health centers. Am J Trop Med Hyg. 2003;68:624-8.
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25. Tham JM, Lee SH, Tan TM, Ting RC, Kara UA. Detection and species determination of malaria parasites by PCR: comparison with microscopy and with ParaSight-F and ICT Malaria Pf tests in a clinical environment. J Clin Microbiol.1999;37:1269-73. 26. Fischer A, Lejczak C, Lambert C, Servais J, Makombe N, Rusine J, et al. Simple DNA extraction method for dried blood spots and comparison of two PCR assays for diagnosis of vertical human immunodeficiency virus type 1 transmission in Rwanda. J Clin Microbiol. 2004;42:16-20.
27. Altschul SF, Madden TL, Schaffer A, Zhang J, Zhang Z, Miller W, et al. Gapped BLAST and PSI-BLAST: a new generation of protein database search programs. Nucleic Acids Res. 1997;25:3389-402.
28. Saiki RK, Scharf S, Faloona F, Mullis KB, Horn GT, Erlich HA, et al. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for the diagnosis of sickle-cell anemia. Biotechnology. 1992;24,476-80.
29. Morassin B, Fabre R, Berry A, Magnaval JF. One years experience of polymerase chain reaction as a routine method for the diagnosis of imported malaria. Am J Trop Med Hyg. 2002;66:503-8.
30. Mendoza NM, Montoya R, García M, Padilla JC, Bruzón LO, Mendoza E, et al. Evaluación de campo de una prueba rápida para el diagnóstico de malaria. Biomédica. 2001;21:313-9.
31. Ferro BE, González IJ, de Carvajal F, Palma GI, Saravia N. Performance of OptiMAL ® in the Diagnosis of Plasmodium vivax and Plasmodium falciparum infection in malaria referral center in Colombia. Mem Inst Oswaldo Cruzi. 2002;97:731-5.
32. van den Broek I, Hill O, Gordillo F, Angarita B, Hamade P, Counihan H, et al. Evaluation of three rapid tests for diagnosis of P. falciparum and P. vivax malaria in Colombia. Am J Trop Med Hyg. 2006;75:1209-15.
33. Londoño B, Carmona J, Blair S. Comparación de los métodos Optimal ® y gota gruesa para el diagnóstico de malaria en una zona endémica sin epidemia. Biomédica.2002;22:466-75.
34. Humar A, Harrington MA, Pillai D, Kain KC. ParaSightTM-Ftest compared with the polymerasechain reaction and microscopy for the diagnosis of P. falciparum malaria in travelers. Am J Trop Med Hyg. 1997;56:44-8.
35. Tjitra E, Suprianto S, McBroom J, Currie BJ, Anstey NM. Persistent ICT Malaria Pf/Pv panmalarial and HRP2 antigen reactivity after treatment of Plasmodium falciparum malaria is associated with gametocytemia and results in false-positive diagnosis of P. vivax in convalescence. J Clin Microbiol. 2001;39:1025-31.
2. Hay SI, Guerra CA, Tótem AJ, Noor AM, Snow RW. The global distribution and population at risk of malaria past, present and future. Lancet Infect Dis. 2004; 4:327-36.
3. Dirección Seccional de Salud de Antioquia. Eventos de vigilancia epidemiológica. Revista Epidemiológica de Antioquia. 2006;28:39-40.
4. Instituto Nacional de Salud. Tablas de notificación semanal obligatoria. Semana 52 de 2006. Consultado: agosto de 2007. Disponible en: http://www.ins.gov.co/pdf/vcsp/Tablas/2006/2006_semana_52.pdf
5. Aron JL. Malaria epidemiology and detectability. Trans R Soc Trop Med Hyg. 1982;76:595-601.
6. Ndao M, Bandyayera E, Kokoskin E, Gyorkos TW, MacLean JD, Ward BJ. Comparison of blood smear, antigen detection, and nested- PCR methods for screening refugees from regions where malaria is endemic after a malaria outbreak in Quebec, Canada. J Clin Microbiol. 2004;42:2694-700.
7. Perandin F, Manca G, Piccolo A, Calderaro A, Galati L, Ricci L, et al. Identification of Plasmodium falciparum, P. vivax, P. ovale and P. malariae and detection of mixed infection in patients with imported malaria in Italy. New Microbiol. 2003;26:91-100.
8. Barat L, Chipipa J, Kolczak M, Sukwa T. Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia? Am J Trop Med Hyg. 1999; 60:1024-30.
9. Garcia M, Marlborough D, Leafasia J, Rieckmann KH.Immunochromatographic test for malaria diagnosis. Lancet. 1996;347:1549.
10. Craig MH, Sharp BL. Comparative evaluation of four techniques for the diagnosis of Plasmodium falciparum infections. Trans R Soc Trop Med Hyg. 1997;91:279-82.
11. Stow NW, Torrens JK, Walker J. An assessment of the accuracy of clinical diagnosis, local microscopy, and a rapid immunochromatographic card test in comparison with expert microscopy in the diagnosis of malaria in rural Kenya. Trans R Soc Trop Med Hyg. 1999;93:519-20.
12. Moody A. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev. 2002;15:66-78.
13. Coleman RE, Maneechai N, Rachapaew N, Kumpitak C, Soyseng V, Mille RS, et al. Field evaluation of the ICT Malaria Pf/Pv immunochromatographic test for the detection of asymptomatic malaria in a Plasmodium falciparum/vivax endemic area in Thailand. Am J Trop Med Hyg. 2002;66 :379-83.
14. World Health Organization. Malaria rapid diagnosis, making it work meeting. Informal consultation on field trials and quality assurance on malaria rapid diagnostic test. 20-23 January 2003. World Health Organization, Regional Office for the Western Pacific. Geneva: WHO; 2003.
15. Palmer CJ, Lindo JF, Klaskala WI, Quesada JA, Kaminsky R, Baum MK, et al. Evaluation of the OptiMAL test for rapid diagnosis of Plasmodium vivax and Plasmodium falciparum malaria. J Clin Microbiol. 1998;36:203-6..
16. Iqbal J, SherA, Hira PR, Al-Owaish R. Comparison of the OptiMAL test with PCR for diagnosis of malaria in immigrants. J Clin Microbiol. 1999;37:3644-6.
17. Piper R, Lebras J, Wentworth L, Hunt-Cooke A, Houze S, Chiodini P, et al. Immunocapture diagnostic assays for malaria using Plasmodium lactate dehydrogenase (pLDH). Am J Trop Med Hyg. 1999; 60: 109-18.
18. Iqbal J, Muneer A, Khalid N, Ahmed MA. Performance of the OptiMAL test for malaria diagnosis among suspected malaria patients at the rural health centers. Am J Trop Med Hyg. 2003;68:624-8.
19. Palmer CJ, Bonilla JA, Bruckner DA, Barnett ED, Millar NS, Haseeb MA, et al. Multicenter study to evaluate the OptiMAL test for rapid diagnosis of malaria in U.S hospitals. J Clin Microbiol. 2003;41:5178-82.
20. Kolaczinski J, Mohammed N, Ali I, Ali M, Khan N, Ezard N, et al. Comparison of the OptiMAL rapid antigen test with field microscopy for the detection of Plasmodium vivax and P. falciparum: considerations for the application of the rapid test in Afghanistan. Ann Trop Med Parasitol. 2004;98:15-20.
21. Kain KC, Lanar DE. Determination of genetic variation within Plasmodium falciparum by using enzymatically amplified DNA from filter paper disks impregnated with whole blood. J Clin Microbiol. 1991;29:1171-4.
22. Kain KC, Brown AE, Mirabelli L, Webster HK. Detection of Plasmodium vivax by polymerase chain reaction in a field study. J Infect Dis. 1993;168:1323-6.
23. Roper C, Elhassan IM, Hviid L, Giha H, Richardson W, Babiker H, et al. Detection of very low level Plasmodium falciparum infections using the nested polymerase chain reaction and a reassessment of the epidemiology of unstable malaria in Sudan. Am J Trop Med Hyg. 1996;54:325-31.
24. Tan TM, Nelson JS, Ng HC, Ting RC, Kara UA. Direct PCR amplification and sequence analysis of ex-trachromosomal Plasmodium DNA from dried blood spots. Acta Trop. 1997;68:105-14.
25. Tham JM, Lee SH, Tan TM, Ting RC, Kara UA. Detection and species determination of malaria parasites by PCR: comparison with microscopy and with ParaSight-F and ICT Malaria Pf tests in a clinical environment. J Clin Microbiol.1999;37:1269-73. 26. Fischer A, Lejczak C, Lambert C, Servais J, Makombe N, Rusine J, et al. Simple DNA extraction method for dried blood spots and comparison of two PCR assays for diagnosis of vertical human immunodeficiency virus type 1 transmission in Rwanda. J Clin Microbiol. 2004;42:16-20.
27. Altschul SF, Madden TL, Schaffer A, Zhang J, Zhang Z, Miller W, et al. Gapped BLAST and PSI-BLAST: a new generation of protein database search programs. Nucleic Acids Res. 1997;25:3389-402.
28. Saiki RK, Scharf S, Faloona F, Mullis KB, Horn GT, Erlich HA, et al. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for the diagnosis of sickle-cell anemia. Biotechnology. 1992;24,476-80.
29. Morassin B, Fabre R, Berry A, Magnaval JF. One years experience of polymerase chain reaction as a routine method for the diagnosis of imported malaria. Am J Trop Med Hyg. 2002;66:503-8.
30. Mendoza NM, Montoya R, García M, Padilla JC, Bruzón LO, Mendoza E, et al. Evaluación de campo de una prueba rápida para el diagnóstico de malaria. Biomédica. 2001;21:313-9.
31. Ferro BE, González IJ, de Carvajal F, Palma GI, Saravia N. Performance of OptiMAL ® in the Diagnosis of Plasmodium vivax and Plasmodium falciparum infection in malaria referral center in Colombia. Mem Inst Oswaldo Cruzi. 2002;97:731-5.
32. van den Broek I, Hill O, Gordillo F, Angarita B, Hamade P, Counihan H, et al. Evaluation of three rapid tests for diagnosis of P. falciparum and P. vivax malaria in Colombia. Am J Trop Med Hyg. 2006;75:1209-15.
33. Londoño B, Carmona J, Blair S. Comparación de los métodos Optimal ® y gota gruesa para el diagnóstico de malaria en una zona endémica sin epidemia. Biomédica.2002;22:466-75.
34. Humar A, Harrington MA, Pillai D, Kain KC. ParaSightTM-Ftest compared with the polymerasechain reaction and microscopy for the diagnosis of P. falciparum malaria in travelers. Am J Trop Med Hyg. 1997;56:44-8.
35. Tjitra E, Suprianto S, McBroom J, Currie BJ, Anstey NM. Persistent ICT Malaria Pf/Pv panmalarial and HRP2 antigen reactivity after treatment of Plasmodium falciparum malaria is associated with gametocytemia and results in false-positive diagnosis of P. vivax in convalescence. J Clin Microbiol. 2001;39:1025-31.
How to Cite
1.
Montoya AE, Menco J, Osorio N, Zuluaga MA, Duque J, Torres G, et al. Concordance between thick blood smear, immunochromatography and polymerase chain reaction for malaria diagnosis. Biomed. [Internet]. 2008 Jun. 1 [cited 2025 Apr. 5];28(2):252-61. Available from: https://revistabiomedicaorg.biteca.online/index.php/biomedica/article/view/96
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