Citation
Parr, Jonathan B.; Belson, Connor; Patel, Jaymin C.; Hoffman, Irving F.; Kamthunzi, Portia; Martinson, Francis E. A.; Tegha, Gerald; Thengolose, Isaac; Drakeley, Chris; & Meshnick, Steven R., et al. (2016). Estimation of Plasmodium falciparum Transmission Intensity in Lilongwe, Malawi, by Microscopy, Rapid Diagnostic Testing, and Nucleic Acid Detection. American Journal of Tropical Medicine and Hygiene, 95(2), 373-377. PMCID: PMC4973184Abstract
Estimates of malaria transmission intensity (MTI) typically rely upon microscopy or rapid diagnostic testing (RDT). However, these methods are less sensitive than nucleic acid amplification techniques and may underestimate parasite prevalence. We compared microscopy, RDT, and polymerase chain reaction (PCR) for the diagnosis of Plasmodium falciparum parasitemia as part of an MTI study of 800 children and adults conducted in Lilongwe, Malawi. PCR detected more cases of parasitemia than microscopy or RDT. Age less than 5 years predicted parasitemia detected by PCR alone (adjusted odds ratio = 1.61, 95% confidence interval = 1.09-2.38, Wald P = 0.02). In addition, we identified one P falciparum parasite with a false-negative RDT result due to a suspected deletion of the histidinerich protein 2 (hrp2) gene and used a novel, ultrasensitive PCR assay to detect low-level parasitemia missed by traditional PCR. Molecular methods should be considered for use in future transmission studies as a supplement to RDT or microscopy.URL
http://dx.doi.org/10.4269/ajtmh.16-0156Reference Type
Journal ArticleYear Published
2016Journal Title
American Journal of Tropical Medicine and HygieneAuthor(s)
Parr, Jonathan B.Belson, Connor
Patel, Jaymin C.
Hoffman, Irving F.
Kamthunzi, Portia
Martinson, Francis E. A.
Tegha, Gerald
Thengolose, Isaac
Drakeley, Chris
Meshnick, Steven R.
Escamilla, Veronica
Emch, Michael E.
Juliano, Jonathan J.