Plasmodium vivax molecular diagnostics in community surveys: pitfalls and solutions

Gruenberg, M; Moniz, CA; Hofmann, NE; Wampfler, R; Koepfli, C; Mueller, I; Monteiro, WM; Lacerda, M; de Melo, GC; Kuehn, A; Siqueira, AM; Felger, I

Author(s): Gruenberg, M; Moniz, CA; Hofmann, NE; Wampfler, R; Koepfli, C; Mueller, I; Monteiro, WM; Lacerda, M; de Melo, GC; Kuehn, A; Siqueira, AM; Felger, I;
Details: Publication Year 2018-01-30,Volume 17,Issue #1,Page 55
Journal Title: Malaria Journal
Publication Type: Journal Article
Abstract: A distinctive feature of Plasmodium vivax infections is the overall low parasite density in peripheral blood. Thus, identifying asymptomatic infected individuals in endemic communities requires diagnostic tests with high sensitivity. The detection limits of molecular diagnostic tests are primarily defined by the volume of blood analysed and by the copy number of the amplified molecular marker serving as the template for amplification. By using mitochondrial DNA as the multi-copy template, the detection limit can be improved more than tenfold, compared to standard 18S rRNA targets, thereby allowing detection of lower parasite densities. In a very low transmission area in Brazil, application of a mitochondrial DNA-based assay increased prevalence from 4.9 to 6.5%. The usefulness of molecular tests in malaria epidemiological studies is widely recognized, especially when precise prevalence rates are desired. Of concern, however, is the challenge of demonstrating test accuracy and quality control for samples with very low parasite densities. In this case, chance effects in template distribution around the detection limit constrain reproducibility. Rigorous assessment of false positive and false negative test results is, therefore, required to prevent over- or under-estimation of parasite prevalence in epidemiological studies or when monitoring interventions.
Publisher: BMC
Research Division(s): Population Health And Immunity
PubMed ID: 29378609
Publisher's Version: https://doi.org/10.1186/s12936-018-2201-0
Open Access at Publisher's Site: https://doi.org/10.1186/s12936-018-2201-0
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2018-03-19 10:02:35

Last Modified: 2018-03-19 10:33:05