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

Kimberly A. Baltzell, Deler Shakely, Michelle Hsiang, Jordan Kemere, Abdullah Suleiman Ali, Anders Björkman, Andreas Mårtensson, Rahila Omar, Kristina Elfving, Mwinyi Msellem, Berit Aydin-Schmidt, Philip J. Rosenthal, Bryan Greenhouse

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

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/mL 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.

Original languageEnglish (US)
Pages (from-to)289-291
Number of pages3
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume88
Issue number2
DOIs
StatePublished - Feb 2013

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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    Baltzell, K. A., Shakely, D., Hsiang, M., Kemere, J., Ali, A. S., Björkman, A., Mårtensson, A., Omar, R., Elfving, K., Msellem, M., Aydin-Schmidt, B., Rosenthal, P. J., & Greenhouse, B. (2013). Prevalence of PCR detectable malaria infection among febrile patients with a negative plasmodium falciparum specific rapid diagnostic test in Zanzibar. American Journal of Tropical Medicine and Hygiene, 88(2), 289-291. https://doi.org/10.4269/ajtmh.2012.12-0095