title: Detection of Plasmodium using filter paper and nested PCR for patients with malaria in Sanliurfa, in Turkey.
abstract: BACKGROUND
  The objective of this study to detect Plasmodium and a subspecies of Plasmodium using filter paper in malaria endemic province, Sanliurfa, in Turkey, compare the results of nested PCR (nPCR) with microscopy for the diagnosis of malaria and present the epidemiological data of malaria.
  
  
  METHODS
  This study was carried out in malaria-endemic Sanliurfa between 2008 and 2011. Finger prick blood samples, thick and thin Giemsa-stained blood smears, were collected from 153 malaria-suspected farmworkers. The Giemsa-stained blood smears were examined microscopically. The obtained DNA products, extracted from blood-spotted filter papers or from the thick blood smears, were analysed by nPCR to amplify the 18S ssrRNA Plasmodium gene with genus and specific primers. The results of the microscopy were compared to the nPCR results.
  
  
  RESULTS
  Of the specimens, 7.2 % were determined as Plasmodium-positive by microscopy, whereas 9.8 % were determined as Plasmodium-positive by nPCR. Of the positive Plasmodium specimens, 93.33 % were identified as P. vivax. Four out of the 15 specimens that were microscopically diagnosed as negative were Plasmodium-positive with nPCR. When compared to the microscopy, the sensitivity, specificity, and positive predictive values of the nPCR were determined as 100, 97.2 and 73.3 %, respectively. nPCR was determined to be more sensitive and specific than microscopy.
  
  
  CONCLUSIONS
  This study revealed that the accurate diagnosis of malaria by nPCR was compulsory in malaria-endemic Sanliurfa and nPCR should be applied routinely in laboratory studies.
authors.affiliation: Department of Medical Microbiology, Vocational School of Health Services, Harran University, İpekyol Avenue No: 1, 63050, Sanliurfa, Turkey. n_doni@hotmail.com.
authors.forename: Nebiye
authors.initials: N
authors.lastname: Yentur Doni
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.
authors.forename: Fadile
authors.initials: F
authors.lastname: Yildiz Zeyrek
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Fırat University, Elazig, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Seyrek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001769:Blood / Q000469:parasitology*; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000235:genetics; D004275:DNA, Ribosomal / Q000235:genetics; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D010209:Paper; D010961:Plasmodium / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016054:DNA, Protozoan; D004275:DNA, Ribosomal; D012337:RNA, Ribosomal, 18S
keywords: Dried blood spot testing; Malaria; Microscopy; Nested PCR; Plasmodium vivax; Turkey