Epidemiologic tools for malaria surveillance in an urban setting of low endemicity along the Colombian Pacific coast.
An evaluation of 3 different methods for malaria diagnosis was carried out in an urban area of low endemicity on the Pacific coast of Colombia. Samples were collected from 833 symptomatic patients at a malaria clinic and examined by the polymerase chain reaction (PCR), quantitative buffy coat (QBC; Becton Dickinson, Franklin Lakes, NJ) method, and the traditional thick blood smear. The prevalence of Plasmodium falciparum malaria was 5.88% by thick blood smear, 7.34% by the QBC method, and 21.87% by PCR. The agreement between microscopists was 99.5%. The agreement between the QBC method and thick blood smear was 96.13% (n = 745). Samples positive by PCR but negative by thick blood smear or conversely negative by PCR and positive by thick blood smear were usually of low-level parasitemias. All 3 methods showed agreement in 76.3% of the samples. Sixty-nine (18.8%) samples were positive by PCR but negative by the other 2 methods. Ten samples were positive by both the QBC method and thick blood smear but negative by PCR; most of them had low-level parasitemias. The use of malaria diagnostic methods for epidemiologic surveillance is discussed.
Carrasquilla
G
G
Fundacion para la Educación Superior, Cali, Colombia.
Banguero
M
M
Sanchez
P
P
Carvajal
F
F
Barker
R H
RH
Gervais
G W
GW
Algarin
E
E
Serrano
A E
AE
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D001769:Blood / Q000469:parasitology; D015139:Blotting, Southern; D002738:Chloroquine / Q000627:therapeutic use; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D017931:DNA Primers / Q000737:chemistry; D016054:DNA, Protozoan / Q000737:chemistry / Q000302:isolation & purification; D004338:Drug Combinations; D004587:Electrophoresis, Agar Gel; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011319:Primaquine / Q000627:therapeutic use; D011739:Pyrimethamine / Q000627:therapeutic use; D011933:Reagent Kits, Diagnostic / Q000469:parasitology; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance; D013413:Sulfadoxine / Q000627:therapeutic use; D014505:Urban Population
D000962:Antimalarials; D017931:DNA Primers; D016054:DNA, Protozoan; D004338:Drug Combinations; D011933:Reagent Kits, Diagnostic; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011319:Primaquine; D011739:Pyrimethamine