Malaria PCR Detection in Cambodian Low-Transmission Settings: Dried Blood Spots versus Venous Blood Samples |
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| Authors: | Lydie Canier Nimol Khim Saorin Kim Rotha Eam Chanra Khean Kaknika Loch Malen Ken Pieter Pannus Philippe Bosman Jorgen Stassijns Fabienne Nackers SweetC Alipon Meng Chuor Char Nguon Chea William Etienne Martin De Smet Jean-Marie Kindermans Didier Ménard |
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| Affiliation: | Institut Pasteur du Cambodge, Phnom Penh, Cambodia; Médecins Sans Frontières, Brussels, Belgium; Epicentre, Paris, France; Médecins Sans Frontières, Tuol Svay Prey I, Chamkarmon, Phnom Penh, Cambodia; National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia |
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| Abstract: | In the context of malaria elimination, novel strategies for detecting very low malaria parasite densities in asymptomatic individuals are needed. One of the major limitations of the malaria parasite detection methods is the volume of blood samples being analyzed. The objective of the study was to compare the diagnostic accuracy of a malaria polymerase chain reaction assay, from dried blood spots (DBS, 5 μL) and different volumes of venous blood (50 μL, 200 μL, and 1 mL). The limit of detection of the polymerase chain reaction assay, using calibrated Plasmodium falciparum blood dilutions, showed that venous blood samples (50 μL, 200 μL, 1 mL) combined with Qiagen extraction methods gave a similar threshold of 100 parasites/mL, ∼100-fold lower than 5 μL DBS/Instagene method. On a set of 521 field samples, collected in two different transmission areas in northern Cambodia, no significant difference in the proportion of parasite carriers, regardless of the methods used was found. The 5 μL DBS method missed 27% of the samples detected by the 1 mL venous blood method, but most of the missed parasites carriers were infected by Plasmodium vivax (84%). The remaining missed P. falciparum parasite carriers (N = 3) were only detected in high-transmission areas. |
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