Format

Send to

Choose Destination
J Infect Dis. 2015 Apr 1;211(7):1128-33. doi: 10.1093/infdis/jiu590. Epub 2014 Oct 24.

Plasma concentration of parasite DNA as a measure of disease severity in falciparum malaria.

Author information

1
Department of Molecular Tropical Medicine and Genetics.
2
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford.
3
Cell Biology and Immunology Group, Wageningen University Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands.
4
MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, United Kingdom Cell Biology and Immunology Group, Wageningen University MRC Keneba, the Gambia.
5
Dev Care Foundation, Dhaka, Bangladesh.
6
Department of Medicine, Ispat Hospital, Rourkela, India.
7
Amani Centre, National Institute for Medical Research, Muheza.
8
Korogwe Research Laboratory, National Institute for Medical Research, Tanga, Tanzania.
9
Hospital Central da Beira.
10
Hospital Central da Beira Faculty of Health Sciences, Catholic University of Mozambique, Beira, Mozambique.

Abstract

In malaria-endemic areas, Plasmodium falciparum parasitemia is common in apparently healthy children and severe malaria is commonly misdiagnosed in patients with incidental parasitemia. We assessed whether the plasma Plasmodium falciparum DNA concentration is a useful datum for distinguishing uncomplicated from severe malaria in African children and Asian adults. P. falciparum DNA concentrations were measured by real-time polymerase chain reaction (PCR) in 224 African children (111 with uncomplicated malaria and 113 with severe malaria) and 211 Asian adults (100 with uncomplicated malaria and 111 with severe malaria) presenting with acute falciparum malaria. The diagnostic accuracy of plasma P. falciparum DNA concentrations in identifying severe malaria was 0.834 for children and 0.788 for adults, similar to that of plasma P. falciparum HRP2 levels and substantially superior to that of parasite densities (P < .0001). The diagnostic accuracy of plasma P. falciparum DNA concentrations plus plasma P. falciparum HRP2 concentrations was significantly greater than that of plasma P. falciparum HRP2 concentrations alone (0.904 for children [P = .004] and 0.847 for adults [P = .003]). Quantitative real-time PCR measurement of parasite DNA in plasma is a useful method for diagnosing severe falciparum malaria on fresh or archived plasma samples.

KEYWORDS:

Plasmodium falciparum; diagnostic accuracy; malaria; plasma DNA; severe disease

PMID:
25344520
PMCID:
PMC4354984
DOI:
10.1093/infdis/jiu590
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center