title: Comparison of nested polymerase chain reaction and microscopy as diagnostic tools in congenital malaria: a study at tjark corneile hillers hospital maumere, indonesia.
abstract: BACKGROUND
  Microscopic detection is the conventional method for detecting malaria parasites. Although it is efficient and inexpensive, it has its limitations. In recent years, polymeras chain reaction (PCR) has been considered superior to microscopy in detecting mixed Plasmodium infections or infections with low parasite density. To determine whether microscopic or nested PCR (nPCR) is better at detecting congenital malaria (CM).
  
  
  METHODS
  Blood smear examination and nPCR were performed with blood samples taken from mothers and their newborns, who were likely to be suffering from CM and in whom one of the symptoms was low birth weight (LBW). The sensitivity and specificity of each method were then compared.
  
  
  RESULTS
  During one year of study, the prevalence of CM among 92 LBW newborns was determined to be 6.8% using microscopy and 7.8% using nPCR. Among the 92 mother-infant paired subjects, CM was detected in 34 subjects (37%) by microscopy and in 39 subjects (42.4%) by nPCR. nPCR was more sensitive (76.5% vs 66.7%) but less specific (77.6% vs 84.9%) than microscopy. When the two methods were compared, nPCR gave significantly better results in diagnosing CM (AUC = 0.770; P < 0.001).
  
  
  CONCLUSIONS
  Although microscopy remains the most appropriate method for the diagnosis of CM in remote areas, nPCR can be considered a complementary test.
authors.affiliation: Department of Pediatrics, Dr. Saiful Anwar Hospital/Faculty of Medicine, University of Brawijaya, Jalan J.A Suprapto No. 2 Malang, East Java 65141, Indonesia.
authors.forename: Natalia Erica
authors.initials: NE
authors.lastname: Jahja
authors.affiliation: Department of Pediatrics, Dr. Saiful Anwar Hospital/Faculty of Medicine, University of Brawijaya, Jalan J.A Suprapto No. 2 Malang, East Java 65141, Indonesia.
authors.forename: Irene Ratridewi
authors.initials: IR
authors.lastname: Huwae
authors.affiliation: Department of Pediatrics, Dr. TC. Hillers Hospital, Jalan Wairklau Maumere, East Nusa Tenggara 86111, Indonesia.
authors.forename: Mario
authors.initials: M
authors.lastname: B Nara
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Leopoldstrasse 5, 80802 Munich, German.
authors.forename: Adinda
authors.initials: A
authors.lastname: Harley
authors.affiliation: Laboratory of Biomedic, Faculty of Medicine, University of Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia.
authors.forename: Tarina
authors.initials: T
authors.lastname: Widaningrum
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Brawijaya, Jalan Veteran Malang, East Java 65145, Indonesia.
authors.forename: Loeki Enggar
authors.initials: LE
authors.lastname: Fitri
keywords: congenital; malaria; microscopy; nested PCR; newborns