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Comparison of microscopy and PCR for the detection of human Plasmodium species and Plasmodium knowlesi in southern Myanmar

Objectives: To determine the distribution of Plasmodium(P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis.Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria pati... Full description

Journal Title: Asian Pacific Journal of Tropical Biomedicine 2017, Vol.7 (8), p.680-685
Main Author: Han, Thu Zar
Other Authors: Han, Kay Thwe , Aye, Kyin Hla , Hlaing, Thaung , Thant, Kyaw Zin , Vythilingam, Indra
Format: Electronic Article Electronic Article
Language: English
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Publisher: Elsevier B.V
ID: ISSN: 2221-1691
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title: Comparison of microscopy and PCR for the detection of human Plasmodium species and Plasmodium knowlesi in southern Myanmar
format: Article
creator:
  • Han, Thu Zar
  • Han, Kay Thwe
  • Aye, Kyin Hla
  • Hlaing, Thaung
  • Thant, Kyaw Zin
  • Vythilingam, Indra
subjects:
  • Arctic medicine
  • Biology (General)
  • Malaria
  • Microscopy
  • parasitic diseases
  • Plasmodium
  • Plasmodium knowlesi
  • Tropical medicine
ispartof: Asian Pacific Journal of Tropical Biomedicine, 2017, Vol.7 (8), p.680-685
description: Objectives: To determine the distribution of Plasmodium(P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis.Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and con firmed by nested PCR.Results: Among the participants, 57(63.3%) were positive and 33(36.7%)were negative by microscopy. Of positive samples, 39(68.4%) were Plasmodium fcalciparum,17(29.8%) Plasmodium vivax and 1(1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40(67.8%), 18(30.5%) and 1(1.7%) respectively. PCR amplified 2 microscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale.P. knowlesi and mixed infections. Microscopy had a very good measure of agreement(κ=0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diagnosis of P. falciparum were 92.5%(95% CI: 79.6-98.4) and 96.0%(95% CI: 86.3-99.5)respectively, whereas for P. vivax were 83.3%(95% CI: 58.6-96.4) and 97.2%(95% CI:90.3-99.7).Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria,those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.
language: eng
source:
identifier: ISSN: 2221-1691
fulltext: no_fulltext
issn:
  • 2221-1691
  • 2588-9222
url: Link


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titleComparison of microscopy and PCR for the detection of human Plasmodium species and Plasmodium knowlesi in southern Myanmar
creatorHan, Thu Zar ; Han, Kay Thwe ; Aye, Kyin Hla ; Hlaing, Thaung ; Thant, Kyaw Zin ; Vythilingam, Indra
creatorcontribHan, Thu Zar ; Han, Kay Thwe ; Aye, Kyin Hla ; Hlaing, Thaung ; Thant, Kyaw Zin ; Vythilingam, Indra
descriptionObjectives: To determine the distribution of Plasmodium(P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis.Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and con firmed by nested PCR.Results: Among the participants, 57(63.3%) were positive and 33(36.7%)were negative by microscopy. Of positive samples, 39(68.4%) were Plasmodium fcalciparum,17(29.8%) Plasmodium vivax and 1(1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40(67.8%), 18(30.5%) and 1(1.7%) respectively. PCR amplified 2 microscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale.P. knowlesi and mixed infections. Microscopy had a very good measure of agreement(κ=0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diagnosis of P. falciparum were 92.5%(95% CI: 79.6-98.4) and 96.0%(95% CI: 86.3-99.5)respectively, whereas for P. vivax were 83.3%(95% CI: 58.6-96.4) and 97.2%(95% CI:90.3-99.7).Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria,those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.
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subjectArctic medicine ; Biology (General) ; Malaria ; Microscopy ; parasitic diseases ; Plasmodium ; Plasmodium knowlesi ; Tropical medicine
ispartofAsian Pacific Journal of Tropical Biomedicine, 2017, Vol.7 (8), p.680-685
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descriptionObjectives: To determine the distribution of Plasmodium(P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis.Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and con firmed by nested PCR.Results: Among the participants, 57(63.3%) were positive and 33(36.7%)were negative by microscopy. Of positive samples, 39(68.4%) were Plasmodium fcalciparum,17(29.8%) Plasmodium vivax and 1(1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40(67.8%), 18(30.5%) and 1(1.7%) respectively. PCR amplified 2 microscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale.P. knowlesi and mixed infections. Microscopy had a very good measure of agreement(κ=0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diagnosis of P. falciparum were 92.5%(95% CI: 79.6-98.4) and 96.0%(95% CI: 86.3-99.5)respectively, whereas for P. vivax were 83.3%(95% CI: 58.6-96.4) and 97.2%(95% CI:90.3-99.7).Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria,those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.
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titleComparison of microscopy and PCR for the detection of human Plasmodium species and Plasmodium knowlesi in southern Myanmar
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notesThu Zar Han;Kay Thwe Han;Kyin Hla Aye;Thaung Hlaing;Kyaw Zin Thant;Indra Vythilingam;MD Programme,Faculty of Medicine & Health Sciences,UCSI University;Department of Medical Research,Lower Myanmar;Vector Borne Diseases Control Unit,Department of Health;Department of Parasitology,University Malaya
abstractObjectives: To determine the distribution of Plasmodium(P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis.Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and con firmed by nested PCR.Results: Among the participants, 57(63.3%) were positive and 33(36.7%)were negative by microscopy. Of positive samples, 39(68.4%) were Plasmodium fcalciparum,17(29.8%) Plasmodium vivax and 1(1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40(67.8%), 18(30.5%) and 1(1.7%) respectively. PCR amplified 2 microscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale.P. knowlesi and mixed infections. Microscopy had a very good measure of agreement(κ=0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diagnosis of P. falciparum were 92.5%(95% CI: 79.6-98.4) and 96.0%(95% CI: 86.3-99.5)respectively, whereas for P. vivax were 83.3%(95% CI: 58.6-96.4) and 97.2%(95% CI:90.3-99.7).Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria,those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.
pubElsevier B.V
doi10.1016/j.apjtb.2017.06.004
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