[Molecular diagnosing of malaria in a tertiary care center in the Brazilian Amazon region].
The routine test for diagnosing malaria is still the thick blood smear, despite its known decreased sensitivity and specificity in situations of low parasite density and mixed infections. The polymerase chain reaction is increasingly being used for molecular detection and identification of Plasmodium species, due to its higher sensitivity and specificity. Nested PCR was performed on whole-blood samples from 344 patients with acute febrile syndrome who came to a tertiary healthcare center in Manaus (State of Amazonas) for diagnostic confirmation of malaria. No malaria cases caused by Plasmodium malariae were detected through the blood smear or PCR. Co-positivity of 96.7%, co-negativity of 62.2% and kappa coefficient of 0.44 were observed between PCR and thick blood smear for Plasmodium falciparum. For Plasmodium vivax, co-positivity of 100%, co-negativity of 78.1% and kappa coefficient of 0.56 were observed. For mixed infection, co-positivity of 100%, co-negativity of 84.9% and kappa coefficient of 0.26 were observed. Polymerase chain reaction detected a high number of mixed infections in the samples analyzed, but its routine use for diagnosing malaria still deserves further discussion.
Gerência de Malária, Fundação de Medicina Tropical do Amazonas, Manaus, AM.
Mônica Regina Farias
MR
Costa
Pedro Paulo Ribeiro
PP
Vieira
Cynthia de Oliveira
Cde O
Ferreira
Marcus Vinícius Guimarães de
MV
Lacerda
Wilson Duarte
WD
Alecrim
Maria das Graças Costa
Md
Alecrim
D000818:Animals; D001938:Brazil / Q000453:epidemiology; D016054:DNA, Protozoan / Q000235:genetics*; D019353:Endemic Diseases; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D010963:Plasmodium falciparum / Q000235:genetics* / Q000302:isolation & purification; D010965:Plasmodium malariae / Q000235:genetics* / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity
D016054:DNA, Protozoan
Diagnóstico molecular da malária em uma unidade de atenção terciária na Amazônia Brasileira.