title: Clinical significance of molecular methods in the diagnosis of imported malaria in returning travelers in Serbia.
abstract: OBJECTIVE
  The goal of this study was to assess the clinical significance of conventional and PCR-based molecular diagnosis in patients with imported malaria in Serbia.
  
  
  METHODS
  Giemsa microscopy, the rapid diagnostic test, and quantitative real-time PCR (qPCR) were used to detect Plasmodium species in 109 whole-blood samples from patients after their return from malaria endemic areas, including those clinically suspected for malaria (n=97) and healthy travelers (n=12) examined as part of epidemiological surveillance.
  
  
  RESULTS
  A total of 45 patients were diagnosed with malaria: 42 (93.3%) by microscopy and three (6.7%) additional ones by qPCR. The agreement between the results of species-specific qPCR and microscopy was 73.3%; it was as high as 90.6% for Plasmodium falciparum infections. Follow-up analysis demonstrated persistence of Plasmodium sp DNA for a mean 6 days after the disappearance of parasitemia on microscopy.
  
  
  CONCLUSIONS
  Due to its sensitivity and specificity, qPCR is a helpful method complementary to microscopy, particularly in cases of low parasitemia. In addition, it is superior to microscopy for species identification.
authors.affiliation: Department of Microbiology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Dakić
authors.affiliation: Center for Parasitic Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Ivović
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Milorad
authors.initials: M
authors.lastname: Pavlović
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Lavadinović
authors.affiliation: Center for Parasitic Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Marković
authors.affiliation: Center for Parasitic Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia. Electronic address: olgicadj@imi.bg.ac.rs.
authors.forename: Olgica
authors.initials: O
authors.lastname: Djurković-Djaković
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008288:Malaria / Q000175:diagnosis*; D016778:Malaria, Falciparum / Q000175:diagnosis; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D018512:Parasitemia / Q000175:diagnosis; D010961:Plasmodium / Q000235:genetics / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D055771:Serbia; D013045:Species Specificity; D014195:Travel; D055815:Young Adult
keywords: Diagnosis; Malaria; Microscopy; Parasitemia; Plasmodium species; Quantitative real-time PCR