title: An innovative tool for moving malaria PCR detection of parasite reservoir into the field.
abstract: BACKGROUND
  To achieve the goal of malaria elimination in low transmission areas such as in Cambodia, new, inexpensive, high-throughput diagnostic tools for identifying very low parasite densities in asymptomatic carriers are required. This will enable a switch from passive to active malaria case detection in the field.
  
  
  METHODS
  DNA extraction and real-time PCR assays were implemented in an "in-house" designed mobile laboratory allowing implementation of a robust, sensitive and rapid malaria diagnostic strategy in the field. This tool was employed in a survey organized in the context of the MalaResT project (NCT01663831).
  
  
  RESULTS
  The real-time PCR screening and species identification assays were performed in the mobile laboratory between October and November 2012, in Rattanakiri Province, to screen approximately 5,000 individuals in less than four weeks and treat parasite carriers within 24-48 hours after sample collection. An average of 240 clinical samples (and 40 quality control samples) was tested every day, six/seven days per week. Some 97.7% of the results were available <24 hours after the collection. A total of 4.9% were positive for malaria. Plasmodium vivax was present in 61.1% of the positive samples, Plasmodium falciparum in 45.9%, Plasmodium malariae in 7.0% and Plasmodium ovale in 2.0%.
  
  
  CONCLUSIONS
  The operational success of this diagnostic set-up proved that molecular testing and subsequent treatment is logistically achievable in field settings. This will allow the detection of clusters of asymptomatic carriers and to provide useful epidemiological information. Fast results will be of great help for staff in the field to track and treat asymptomatic parasitaemic cases. The concept of the mobile laboratory could be extended to other countries for the molecular detection of malaria or other pathogens, or to culture vivax parasites, which does not support long-time delay between sample collection and culture.
authors.forename: Lydie
authors.initials: L
authors.lastname: Canier
authors.forename: Nimol
authors.initials: N
authors.lastname: Khim
authors.forename: Saorin
authors.initials: S
authors.lastname: Kim
authors.forename: Vincent
authors.initials: V
authors.lastname: Sluydts
authors.forename: Somony
authors.initials: S
authors.lastname: Heng
authors.forename: Dany
authors.initials: D
authors.lastname: Dourng
authors.forename: Rotha
authors.initials: R
authors.lastname: Eam
authors.forename: Sophy
authors.initials: S
authors.lastname: Chy
authors.forename: Chanra
authors.initials: C
authors.lastname: Khean
authors.forename: Kaknika
authors.initials: K
authors.lastname: Loch
authors.forename: Malen
authors.initials: M
authors.lastname: Ken
authors.forename: Hokkean
authors.initials: H
authors.lastname: Lim
authors.forename: Sovannaroath
authors.initials: S
authors.lastname: Siv
authors.forename: Sochantha
authors.initials: S
authors.lastname: Tho
authors.forename: Pascal
authors.initials: P
authors.lastname: Masse-Navette
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gryseels
authors.forename: Sambunny
authors.initials: S
authors.lastname: Uk
authors.forename: Karel
authors.initials: K
authors.lastname: Van Roey
authors.forename: Koen Peeters
authors.initials: KP
authors.lastname: Grietens
authors.forename: Mao
authors.initials: M
authors.lastname: Sokny
authors.forename: Boukheng
authors.initials: B
authors.lastname: Thavrin
authors.forename: Char Meng
authors.initials: CM
authors.lastname: Chuor
authors.forename: Vincent
authors.initials: V
authors.lastname: Deubel
authors.forename: Lies
authors.initials: L
authors.lastname: Durnez
authors.forename: Marc
authors.initials: M
authors.lastname: Coosemans
authors.affiliation: Institut Pasteur du Cambodge, Phnom Penh, Cambodia. dmenard@pasteur-kh.org.
authors.forename: Didier
authors.initials: D
authors.lastname: Ménard
mesh_terms: D058345:Asymptomatic Infections; D002160:Cambodia / Q000453:epidemiology; D002353:Carrier State / Q000175:diagnosis* / Q000469:parasitology; D003430:Cross-Sectional Studies; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D008403:Mass Screening / Q000379:methods; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D017720:Molecular Epidemiology / Q000379:methods; D010274:Parasitology / Q000379:methods*; D010961:Plasmodium / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D013997:Time Factors