Comparison of Various Techniques for the Diagnosis of Clinically Suspected Cases of Malaria with Special Reference to PCR
Authors/Creators
- 1. Senior Resident, Department of Microbiology, TNMC & BYL Nair Charitable Hospital, Mumbai
- 2. Additional Professor, Department of Microbiology TNMC & BYL Nair Charitable Hospital, Mumbai
- 3. Professor, Department of Microbiology TNMC & BYL Nair Charitable Hospital, Mumbai
Description
Introduction: Malaria is one of the most successful and pervasive parasitic infections ever known to mankind attributable to its treatability. Its early diagnosis using rapid diagnostic tests contributes towards effective management. Increasing mortality and morbidity resulting from malaria makes it crucial that a rapid and accurate diagnosis be made, in order to initiate prompt treatment in clinically suspected cases. Aims: To compare between various techniques for the diagnosis of clinically suspected cases of Malaria and also to evaluate the diagnostic utility of PCR. Material and Methods: A total of 200 clinically suspected cases of malaria presenting with fever and chills were included in the descriptive study. The samples were processed for detection of malaria parasite or its antigen. Peripheral blood smear examination (PSMP) was done using Leishman’s staining, Rapid Malaria Antigen Test (RMAT) by Accucare ( Lab care diagnostics Pvt Ltd) and conventional PCR for detection of Plasmodium species (P. falciparum, P. vivax) using Malaria diagnosis kit (ACTIVETM, Imperial Life Sciences Pvt Ltd, Gurgaon, Haryana, India) were performed on each sample. The diagnostic efficacy of each test against the appropriate gold standard has been studied using indices such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy along with 95% CI as the precision of their estimates. The entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS ver 16.0, Inc. Chicago). Results: Out of 200 cases, PSMP detected and identified malarial parasites in 28(14%), RMAT in 35(17.5%) and PCR in 27(13.5%) of the cases. In 28 out of 200 samples, malaria positivity was seen by both PSMP and RMAT and speciation were in agreement (100%). Whereas PCR showed agreement in 22 cases in terms of speciation. Sensitivity of RMAT and PCR was 100% and 85.7% and specificity was 95.9% and 98.3% respectively. Additionally, the association between PSMP and RMAT, PSMP and PCR was statistically significant (P value=0.001). Conclusions: Rapid diagnostic tests and PCR technique can be useful adjuncts to microscopy to diagnose malaria cases accurately.
Abstract (English)
Introduction: Malaria is one of the most successful and pervasive parasitic infections ever known to mankind attributable to its treatability. Its early diagnosis using rapid diagnostic tests contributes towards effective management. Increasing mortality and morbidity resulting from malaria makes it crucial that a rapid and accurate diagnosis be made, in order to initiate prompt treatment in clinically suspected cases. Aims: To compare between various techniques for the diagnosis of clinically suspected cases of Malaria and also to evaluate the diagnostic utility of PCR. Material and Methods: A total of 200 clinically suspected cases of malaria presenting with fever and chills were included in the descriptive study. The samples were processed for detection of malaria parasite or its antigen. Peripheral blood smear examination (PSMP) was done using Leishman’s staining, Rapid Malaria Antigen Test (RMAT) by Accucare ( Lab care diagnostics Pvt Ltd) and conventional PCR for detection of Plasmodium species (P. falciparum, P. vivax) using Malaria diagnosis kit (ACTIVETM, Imperial Life Sciences Pvt Ltd, Gurgaon, Haryana, India) were performed on each sample. The diagnostic efficacy of each test against the appropriate gold standard has been studied using indices such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy along with 95% CI as the precision of their estimates. The entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS ver 16.0, Inc. Chicago). Results: Out of 200 cases, PSMP detected and identified malarial parasites in 28(14%), RMAT in 35(17.5%) and PCR in 27(13.5%) of the cases. In 28 out of 200 samples, malaria positivity was seen by both PSMP and RMAT and speciation were in agreement (100%). Whereas PCR showed agreement in 22 cases in terms of speciation. Sensitivity of RMAT and PCR was 100% and 85.7% and specificity was 95.9% and 98.3% respectively. Additionally, the association between PSMP and RMAT, PSMP and PCR was statistically significant (P value=0.001). Conclusions: Rapid diagnostic tests and PCR technique can be useful adjuncts to microscopy to diagnose malaria cases accurately.
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IJPCR,Vol15,Issue9,Article62.pdf
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Additional details
Dates
- Accepted
-
2023-08-29
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue9,Article62.pdf
- Development Status
- Active
References
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