Prevalence of PCR detectable malaria infection among febrile patients with a negative Plasmodium falciparum specific rapid diagnostic test in Zanzibar

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,...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2013-02, Vol.88 (2), p.289-291
Main Authors: Baltzell, Kimberly A, Shakely, Deler, Hsiang, Michelle, Kemere, Jordan, Ali, Abdullah Suleiman, Björkman, Anders, Mårtensson, Andreas, Omar, Rahila, Elfving, Kristina, Msellem, Mwinyi, Aydin-Schmidt, Berit, Rosenthal, Philip J, Greenhouse, Bryan
Format: Article
Language:English
Subjects:
Adolescent
Adult
Child
Child, Preschool
DNA Primers
DNA, Protozoan - genetics
Female
Humans
Infant
Malaria - diagnosis
Malaria - epidemiology
Malaria - parasitology
Male
Microscopy
Plasmodium falciparum - genetics
Plasmodium falciparum - isolation & purification
Plasmodium falciparum - pathogenicity
Plasmodium vivax - genetics
Plasmodium vivax - isolation & purification
Plasmodium vivax - pathogenicity
Polymerase Chain Reaction - methods
Prevalence
Short Report
Surveys and Questionnaires
Tanzania - epidemiology
Travel
Young Adult
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Summary: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/μL 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.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.2012.12-0095