title: Detection of mixed Plasmodium falciparum & P. vivax infections by nested-PCR in Pakistan, Iran & Afghanistan.
abstract: OBJECTIVE
  Species identification and information on transmission pattern of malaria parasite in any malaria endemic area is key to success for a malaria control programme. In this investigation, malaria diagnosis using molecular method was used to assess the transmission pattern of malaria parasite in three malaria endemic regions: Afghanistan, Iran and Pakistan.
  
  
  METHODS
  Blood samples were collected from the patients presenting with vivax malaria from Afghanistan (n=108), Iran (n=200) and Pakistan (n=199). Malaria parasite detection was made by the gold standard (microscopy) and also nested-PCR assay, using 18S small sub-unit ribosomal RNA (ssrRNA) gene.
  
  
  RESULTS
  Based on microscopy method, the level of mixed infection was zero to 2.5 per cent; however, nested-PCR assay detected 6.5, 22 and 23.5 per cent mixed infections in samples collected from Afghanistan, Iran and Pakistan, respectively. The present results showed that the co-infection of P. vivax with P. falciparum was frequent in malaria endemic regions of Iran and Pakistan.
  
  
  CONCLUSIONS
  The present data suggest the need for improving microscopy diagnosis method and the clinician should also have careful clinical observation, along with the reports on Giemsa- stained thick blood films, particularly in summer time when P. vivax is predominant. Also sharing information on transmission pattern of mixed infection among these countries may help in designing better control strategies for malaria.
authors.affiliation: Malaria & Vector Research Group (MVRG), Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran. zakeris@yahoo.com
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Zakeri
authors.forename: Qutbuddin
authors.initials: Q
authors.lastname: Kakar
authors.forename: Faezeh
authors.initials: F
authors.lastname: Ghasemi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Raeisi
authors.forename: Waqar
authors.initials: W
authors.lastname: Butt
authors.forename: Najibullah
authors.initials: N
authors.lastname: Safi
authors.forename: Mandana
authors.initials: M
authors.lastname: Afsharpad
authors.forename: Muhammad Suleiman
authors.initials: MS
authors.lastname: Memon
authors.forename: Saber
authors.initials: S
authors.lastname: Gholizadeh
authors.forename: Masoud
authors.initials: M
authors.lastname: Salehi
authors.forename: Hoda
authors.initials: H
authors.lastname: Atta
authors.forename: Ghasem
authors.initials: G
authors.lastname: Zamani
authors.forename: Navid Dinparast
authors.initials: ND
authors.lastname: Djadid
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D003140:Communicable Disease Control / Q000379:methods*; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics / Q000635:transmission; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000235:genetics*; D010966:Plasmodium vivax / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods*