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Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2

Authors: OKANGBA Chika

Publication Type: Journal article

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Abstract

Plasmodium nucleic acids have been detected in serum and plasma, but there is little published 22 data describing the diagnostic performance of malaria nucleic acid amplification tests (NAATs) 23 using these specimen types. Previously, our group described a multiplex NAAT for the detection 24 of dengue virus, Leptospira, and Plasmodium species with a call-out for P. falciparum (the DLM 25 assay) that demonstrated sensitive detection of P. falciparum from plasma samples during initial 26 evaluation. In this study, we evaluated the sensitivity and specificity of P. falciparum detection 27 in febrile Nigerian patients using the DLM assay, microscopy, and a rapid diagnostic test 28 (BinaxNOWÂ® Malaria). Assay performance was compared using a composite reference, which 29 was considered positive if malaria was detected by two or more methods. Serum (n=182) or 30 plasma (n=148) was tested from 317 patients; average sample volume was 70ÂµL (range 5-31 300ÂµL). The sensitivity and specificity of the DLM assay were 97.1% and 93.5%, respectively. 32 Sensitivity of the malaria rapid diagnostic test (98.1%) was similar to the DLM assay and both 33 proved significantly more sensitive than microscopy (79%; p<0.0001). When analysis was 34 limited to samples with â‰¥75ÂµL of serum or plasma, sensitivity of the DLM assay improved to 35 99% and specificity was 97.5%. For P. falciparum cases, crossing threshold values in the DLM 36 assay correlated with the parasite density detected by microscopy (Spearmanâ€™s rank correlation 37 coefficient, p<0.0001). In conclusion, malaria detection using the DLM assay on serum or 38 plasma is more sensitive than, and equally specific to, microscopy in patients with P. falciparum 39 malaria.

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OKANGBA,C. . (0000). Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2, 0 (), 0-0.

OKANGBA,C. . "Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2" 0, no (), (0000): 0-0.

OKANGBA,C. and . (0000). Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2, 0 (), pp0-0.

OKANGBAC, . Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2. 0000, 0 ():0-0.

OKANGBA,Chika , . "Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2", 0 . (0000) : 0-0.

O.Chika , "Molecular Testing for Plasmodium falciparum using Serum or Plasma and Comparison 1 with Microscopy and Rapid Diagnostic Testing in Febrile Nigerian Patients 2" vol.0, no., pp. 0-0, 0000.

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