title: Quality of malaria diagnosis and molecular confirmation of Plasmodium ovale curtisi in a rural area of the southeastern region of Ethiopia.
abstract: BACKGROUND
  Approximately 50 million people (60 %) live in malaria risk areas in Ethiopia, at altitudes below 2000 m. According to official data, 60-70 % of malaria cases are due to Plasmodium falciparum, and 40-30 % by Plasmodium vivax. The species Plasmodium ovale was detected in 2013 in the northwest of the country, being the first report of the presence of this species in Ethiopia since the 60 s. The aim of this study was to assess the diagnosis by microscopy and PCR, and demonstrate the presence of other Plasmodium species in the country.
  
  
  METHODS
  The survey was conducted in Bulbula, situated in the Rift Valley (West Arsi Province, Oromia Region). From December 2010 to October 2011, 3060 samples were collected from patients with symptoms of malaria; the diagnosis of malaria was done by microscopy and confirmation by PCR.
  
  
  RESULTS
  736 samples were positive for malaria by microscopy. After removing the 260 samples (109 positives and 151 negatives) for which it was not possible to do PCR, there were a total of 2800 samples, 1209 are used for its confirmation by PCR and quality control (627 are positives and 582 negatives by microscopy). From the 627 positive samples, 604 were confirmed as positive by PCR, 23 false positives were detected, and the group of 582 negative samples, 184 were positive by PCR (false negatives), which added to the previous positive samples is a total of 788, positive samples for some species of Plasmodium sp. 13.3 % more positives were detected with the PCR than the microscopy. Importantly, 23 samples were detected by PCR as P. ovale, after the sequencing of these samples was determined as P. ovale curtisi.
  
  
  CONCLUSIONS
  The PCR detected more positive samples than the microscopy; in addition, P. ovale and P. ovale/P. vivax were detected that had not been detected by microscopy, which can affect in the infection control.
authors.affiliation: National Centre of Tropical Medicine, Institute of Health Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain. pberzosa@isciii.es.
authors.forename: Pedro Berzosa
authors.initials: PB
authors.lastname: Díaz
authors.affiliation: National Centre of Tropical Medicine, Institute of Health Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain. patricia_mula_lozano@yahoo.es.
authors.forename: Patricia Mula
authors.initials: PM
authors.lastname: Lozano
authors.affiliation: Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain. jramosrincon@yahoo.es.
authors.forename: Jose Manuel Ramos
authors.initials: JM
authors.lastname: Rincón
authors.affiliation: National Centre of Tropical Medicine, Institute of Health Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain. luzgarcia@isciii.es.
authors.forename: Luz
authors.initials: L
authors.lastname: García
authors.affiliation: Gambo General Rural Hospital, Gambo, West Arsi Province, Oromia Region, Ethiopia. francireyes80@gmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Reyes
authors.affiliation: National Centre of Tropical Medicine, Institute of Health Carlos III, C/Monforte de Lemos 5, 28029, Madrid, Spain. abenito@isciii.es.
authors.forename: Agustín Benito
authors.initials: AB
authors.lastname: Llanes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D041122:Plasmodium ovale / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012680:Sensitivity and Specificity; D055815:Young Adult