武汉市两种输入性卵形疟巢式PCR检测

目的 了解巢式PCR鉴别卵形疟curtisi及变种wallikeri效果。方法 收集武汉市2008—2015年疟疾患者血样和流行病学资料。提取患者血样中的疟原虫DNA,进行巢式 PCR 检测。结果 采用巢式PCR检测疟疾患者282例,其中恶性疟原虫206例、间日疟原虫62例、三日疟原虫6例、卵形疟原虫19例。巢式PCR结果显示,卵形疟原虫经典型curtisi 和变种型wallikeri 分别扩增出800 bp和780 bp目的 条带。2012—2015年卵形疟占当年疟疾患者分别为4.1%（2/49）、12.2%（9/74）、8.2%（4/49）、11.4%（4/35）,卵形疟总数占全部病例的6.74%,其中,经典型curtisi 14例,变种型wallikeri 3例,混合感染2例,变种型wallikeri检出率占卵形疟26.3%。19例卵形疟病例全部为男性,感染输入地主要分布在撒哈拉沙漠以南地区,2例卵形疟混合感染分别来自安哥拉和尼日利亚。其中有2例卵形疟原虫curtisi型镜检 结果分别为间日疟和恶性疟,1例血片重新复核后为卵形疟,另1例巢式PCR检测为间日疟和卵形疟混合感染型。结论 分子生物学技术可以减少卵形疟误诊的情况;加强卵形疟curtisi及变种wallikeri的巢式PCR 检测,避免误诊。

Detection of two kinds of imported Plasmodium ovale by nested PCR in Wuhan

Objective To understand the identification results of Plasmodium ovale curtisi and Plasmodium ovale wallikeri by nested PCR. Methods The blood samples were collected from patients with malaria from 2008 to 2015, the epidemiological data were collected, and nested PCR was used to amplify the samples. Results A total of 282 blood samples of patients with malaria from 2008 to 2015 were tested by nested PCR; there were 206 cases of P. falciparum, 62 cases of P. vivax, 6 cases of P. malariae, and 19 cases of P. ovale. Nested-PCR for curtisi and wallikeri produced bands of 800 bp and 780 bp. The detection rate of P. ovale was 4.1% (2/49）, 12.2% (9/74）, 8.2% (4/49）, and 11.4% (4/35）, from 2012 to 2015, respectively. P. ovale accounted for 6.74% of the total cases, and among them, there were 14 cases of P. ovale curtisi, 3 cases of P. ovale wallikeri, and 2 cases of mixed infection with both subtypes. The detection rate of wallikeri subtype was 26.3%. All 19 ovale malaria cases were male, and the infected input regions were mainly distributed in sub-Saharan region, and 2 cases of mixed infection were from Angola and Nigeria. Two cases of P. ovale curtisi were reported as P. vivax and P. falciparum with microscopic examinations, one case was checked for P. ovale, another case was detected as a mixed infective type of P. vivax and P. ovale by nested PCR. Conclusion Molecular biology techniques can reduce misdiagnosis, and the detection of P. ovale curtisi and wallikeri subtype should be enhanced to avoid missed diagnosis of ovale malaria.