title: Epidemiology of Plasmodium infections in Flores Island, Indonesia using real-time PCR.
abstract: BACKGROUND
  DNA-based diagnostic methods have been shown to be highly sensitive and specific for the detection of malaria. An 18S-rRNA-based, real-time polymerase chain reaction (PCR) was used to determine the prevalence and intensity of Plasmodium infections on Flores Island, Indonesia.
  
  
  METHODS
  Microscopy and real-time multiplex PCR for the detection of Plasmodium species was performed on blood samples collected in a population-based study in Nangapanda Flores Island, Indonesia.
  
  
  RESULTS
  A total 1,509 blood samples were analysed. Real-time PCR revealed prevalence for Plasmodium falciparum, Plasmodium vivax, and Plasmodium malariae to be 14.5%, 13.2%, and 1.9% respectively. Sub-microscopic parasitaemia were found in more than 80% of all positive cases. The prevalence of P. falciparum and P. vivax was significantly higher in subjects younger than 20 years (p ≤ 0.01). In the present study, among non-symptomatic healthy individuals, anaemia was strongly correlated with the prevalence and load of P. falciparum infections (p ≤ 0.01; p = 0.02) and with the load of P. vivax infections (p = 0.01) as detected with real-time PCR. Subjects with AB blood group tend to have a higher risk of being infected with P. falciparum and P. vivax when compared to other blood groups.
  
  
  CONCLUSIONS
  The present study has shown that real-time PCR provides more insight in the epidemiology of Plasmodium infections and can be used as a monitoring tool in the battle against malaria. The unsurpassed sensitivity of real-time PCR reveals that sub microscopic infections are common in this area, which are likely to play an important role in transmission and control.
  
  
  BACKGROUND
  Trials number ISRCTN83830814.
authors.forename: Maria M M
authors.initials: MM
authors.lastname: Kaisar
authors.forename: Taniawati
authors.initials: T
authors.lastname: Supali
authors.forename: Aprilianto E
authors.initials: AE
authors.lastname: Wiria
authors.forename: Firdaus
authors.initials: F
authors.lastname: Hamid
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Wammes
authors.forename: Erliyani
authors.initials: E
authors.lastname: Sartono
authors.forename: Adrian J F
authors.initials: AJ
authors.lastname: Luty
authors.forename: Eric A T
authors.initials: EA
authors.lastname: Brienen
authors.forename: Maria
authors.initials: M
authors.lastname: Yazdanbakhsh
authors.forename: Lisette
authors.initials: L
authors.lastname: van Lieshout
authors.forename: Jaco J
authors.initials: JJ
authors.lastname: Verweij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008288:Malaria / Q000097:blood / Q000453:epidemiology* / Q000469:parasitology*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010961:Plasmodium / Q000235:genetics* / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D055815:Young Adult
chemical_list: D006454:Hemoglobins