title: Comparison of microscopy, nested-PCR, and Real-Time-PCR assays using high-throughput screening of pooled samples for diagnosis of malaria in asymptomatic carriers from areas of endemicity in Myanmar.
abstract: Asymptomatic infection is an important obstacle for controlling disease in countries where malaria is endemic. Because asymptomatic carriers do not seek treatment for their infections, they can have high levels of gametocytes and constitute a reservoir available for new infection. We employed a sample pooling/PCR-based molecular detection strategy for screening malaria infection in residents from areas of Myanmar where malaria is endemic. Blood samples (n = 1,552) were collected from residents in three areas of malaria endemicity (Kayin State, Bago, and Tanintharyi regions) of Myanmar. Two nested PCR and real-time PCR assays showed that asymptomatic infection was detected in about 1.0% to 9.4% of residents from the surveyed areas. The sensitivities of the two nested PCR and real-time PCR techniques were higher than that of microscopy examination (sensitivity, 100% versus 26.4%; kappa values, 0.2 to 0.5). Among the three regions, parasite-positive samples were highly detected in subjects from the Bago and Tanintharyi regions. Active surveillance of residents from regions of intense malaria transmission would reduce the risk of morbidity and mitigate transmission to the population in these areas of endemicity. Our data demonstrate that PCR-based molecular techniques are more efficient than microscopy for nationwide surveillance of malaria in countries where malaria is endemic.
authors.affiliation: Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Soe-Soe
authors.initials: SS
authors.lastname: Han
authors.affiliation: Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Cho
authors.initials: C
authors.lastname: Cho
authors.affiliation: Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
authors.forename: Yang
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
authors.forename: Seong-Kyun
authors.initials: SK
authors.lastname: Lee
authors.affiliation: World Health Organization, Mayangone Township, Yangon, Myanmar.
authors.forename: Gawrie N L
authors.initials: GN
authors.lastname: Galappaththy
authors.affiliation: World Health Organization, Mayangone Township, Yangon, Myanmar.
authors.forename: Krongthong
authors.initials: K
authors.lastname: Thimasarn
authors.affiliation: World Health Organization, Mayangone Township, Yangon, Myanmar.
authors.forename: Myat Thu
authors.initials: MT
authors.lastname: Soe
authors.affiliation: World Health Organization, Mayangone Township, Yangon, Myanmar.
authors.forename: Htet Wai
authors.initials: HW
authors.lastname: Oo
authors.affiliation: Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Myat Phone
authors.initials: MP
authors.lastname: Kyaw
authors.affiliation: Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea ethan@kangwon.ac.kr.
authors.forename: Eun-Taek
authors.initials: ET
authors.lastname: Han
mesh_terms: D001769:Blood / Q000469:parasitology; D002353:Carrier State / Q000175:diagnosis*; D057166:High-Throughput Screening Assays; D006801:Humans; D008288:Malaria / Q000175:diagnosis*; D008853:Microscopy / Q000379:methods*; D002052:Myanmar; D016133:Polymerase Chain Reaction / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity