Publication: Comparison of three molecular methods for the detection and speciation of Plasmodium vivax and Plasmodium falciparum
1
Accepted Date
2007-09-15
Issued Date
2007-09-15
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Language
eng
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application/pdf
No. of Pages/File Size
378 kb
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Mahidol University.
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BioMed Central
Bibliographic Citation
Malaria Journal. Vol.6, No.1 (2007), 1-7
Suggested Citation
Prapaporn Boonma, Peter R Christensen, Rossarin Suwanarusk, Ric N Price, Bruce Russell, Usa Lek-Uthai, อุษา เล็กอุทัย Comparison of three molecular methods for the detection and speciation of Plasmodium vivax and Plasmodium falciparum. Malaria Journal. Vol.6, No.1 (2007), 1-7. doi:10.1186/1475-2875-6-124 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/2179
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Title
Comparison of three molecular methods for the detection and speciation of Plasmodium vivax and Plasmodium falciparum
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Abstract
Background: Accurate diagnosis of Plasmodium spp. is essential for the rational treatment of malaria. Despite its many disadvantages, microscopic examination of blood smears remains the current "gold standard" for malaria detection and speciation. PCR assays offer an alternative to microscopy which has been shown to have superior sensitivity and specificity. Unfortunately few comparative studies have been done on the various molecular based speciation methods.
Methods: The sensitivity, specificity and cost effectiveness of three molecular techniques were compared for the detection and speciation of Plasmodium falciparum and Plasmodium vivax from dried blood spots collected from 136 patients in western Thailand. The results from the three
molecular speciation techniques (nested PCR, multiplex PCR, and real-time PCR) were used to develop a molecular consensus (two or more identical PCR results) as an alternative gold standard.
Results: According to the molecular consensus, 9.6% (13/136) of microscopic diagnoses yielded false negative results. Multiplex PCR failed to detect P. vivax in three mixed isolates, and the nested
PCR gave a false positive P. falciparum result in one case. Although the real-time PCR melting curve analysis was the most expensive method, it was 100% sensitive and specific and least time consuming of the three molecular techniques investigated.
Conclusion: Although microscopy remains the most appropriate method for clinical diagnosis in a field setting, its use as a gold standard may result in apparent false positive results by superior techniques. Future studies should consider using more than one established molecular methods as
a new gold standard to assess novel malaria diagnostic kits and PCR assays.
Sponsorship
This study was funded by the Faculty of Public Health, Mahidol University(UL), NHMRC Howard Florey Fellowship(BMR) and Charles
Darwin University Honours student grant(PRC). BMR is supported by a NHMRC Howard Florey Fellowship. RP and RS are funded by a Wellcome Trust Career Development Award, affiliated to the Wellcome Trust –
Mahidol University – Oxford Tropical Medicine Research Programme (074637).