Plasmodium vivax molecular diagnostics in community surveys: pitfalls and solutions

Gruenberg, Maria and Moniz, Clara Antunes and Hofmann, Natalie Ellen and Wampfler, Rahel and Koepfli, Cristian and Mueller, Ivo and Monteiro, Wuelton Marcelo and Lacerda, Marcus and de Melo, Gisely Cardoso and Kuehn, Andrea and Siqueira, Andre M. and Felger, Ingrid. (2018) Plasmodium vivax molecular diagnostics in community surveys: pitfalls and solutions. Malaria Journal, 17. p. 55.

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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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Molecular Diagnostics (Felger)
UniBasel Contributors:Wampfler, Rahel and Hofmann, Natalie and Grünberg, Maria and Antunes Moniz, Clara and Köpfli, Christian and Felger, Ingrid
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:BioMed Central
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:09 Feb 2018 15:43
Deposited On:09 Feb 2018 15:42

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