title: Post-arrival screening for malaria in asymptomatic refugees using real-time PCR.
abstract: Malaria is a significant health risk to refugee populations originating from endemic areas, but there is little consensus on screening and/or treatment approaches for malaria in this population. Furthermore, detection of malaria in semi-immune asymptomatic refugees is limited by the sensitivity of diagnostic tests used for screening. We determined the prevalence of malaria by microscopy and real-time polymerase chain reaction (PCR) in a consecutive population of 324 asymptomatic refugees examined in Edmonton, Canada, during 2009-2010. Although all thick and thin blood smear results were negative, 10 subjects (3.1%) tested PCR positive for Plasmodium DNA. Interestingly, 6 of 10 PCR positive subjects are at risk of malaria relapse by P. vivax or P. ovale infections. These results suggest that appropriate guidelines for malaria screening should consider the risk of relapsing infections, and they highlight the potential usefulness of real-time PCR in the diagnosis of asymptomatic malaria.
authors.affiliation: Provincial Laboratory for Public Health, Edmonton, Alberta, Canada. chelsea.matisz@albertahealthservices.ca
authors.forename: Chelsea E
authors.initials: CE
authors.lastname: Matisz
authors.forename: Prenilla
authors.initials: P
authors.lastname: Naidu
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Shokoples
authors.forename: Diane
authors.initials: D
authors.lastname: Grice
authors.forename: Valerie
authors.initials: V
authors.lastname: Krinke
authors.forename: Stuart Z
authors.initials: SZ
authors.lastname: Brown
authors.forename: Kinga
authors.initials: K
authors.lastname: Kowalewska-Grochowska
authors.forename: Stan
authors.initials: S
authors.lastname: Houston
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Yanow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012036:Refugees; D012680:Sensitivity and Specificity; D055815:Young Adult