title: Detection of mixed-species infections of Plasmodium falciparum and Plasmodium vivax by nested PCR and rapid diagnostic tests in southeastern Iran.
abstract: Coexistence of two species of Plasmodium in a single host has disrupted the diagnosis and treatment of malaria. This study was designed to evaluate the ability of rapid diagnostic test (RDT) kits for the diagnosis of mixed-species malaria infections in southeastern Iran. A total of 100 malaria patients were included in the study out of 164 randomly suspected symptomatic malaria patients from May to November 2012. Nested polymerase chain reaction (PCR) was also used to judge the ability of microscopy versus RDT kits for detecting mixed species. The sensitivity of light microscopy for the detection of mixed-species malaria infections was 16.6% (95% confidence interval [CI] = 3-49.1). Nested PCR revealed 12 patients with mixed-species infection. The CareStart Pv/Pf Combo kit detected 58% of the mixed-species infections, which were determined by nested PCR (sensitivity = 58.3%; 95% CI = 28.5-83.5). For identifying P. falciparum, P. vivax, and mixed-species infections, the concordance rates (kappa statistics) of microscopy and CareStart Pv/Pf Combo kit with nested PCR were 0.76 and 0.79, respectively (P = 0.001). This study underlines the effectiveness of RDT kits to improve the differentiation of mixed-species malaria infections in endemic areas where the prevalence of chloroquine resistance is high.
authors.affiliation: Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Reyhaneh
authors.initials: R
authors.lastname: Ehtesham
authors.affiliation: Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Fazaeli
authors.affiliation: Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Raeisi
authors.affiliation: Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keshavarz
authors.affiliation: Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran aliehsan2001@yahoo.com.
authors.forename: Aliehsan
authors.initials: A
authors.lastname: Heidari
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology*; D016054:DNA, Protozoan / Q000235:genetics*; D005260:Female; D006801:Humans; D007492:Iran; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000235:genetics* / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D055815:Young Adult
chemical_list: D016054:DNA, Protozoan