An investigation on the prevalence and efficiency of immunochromatographic testing in suspected malarial patients of Rawalpindi and Islamabad, Pakistan

Abstract

The information generated from the completion of the genome sequence of Plasmodium falciparum in 2002 helped revolutionize molecular biological research on malarial parasites. Malaria is among the oldest documented diseases of humans and even today organisms in the genus Plasmodium infect more people than do the vectors of any other infectious disease (1). Temporal variation of malaria cases shows a significant positive association with meteorological variables including average monthly rainfall and temperature (2). According to the World Health Organization (WHO), approximately 135 to 287 million cases and 473,000 to 789,000 deaths due to malaria were reported in 2012 (3).Four species of malaria parasites, Plasmodium falciparum, Plasmodium vivax, Plasmodium ovlae, and Plasmodium malariae, are known to infect humans (4). Among these, P. vivax puts billions of the world's population at risk of infection due to greater survival ability in challenging environments (5-7). Malarial infection is one of the gravest problems prevailing in Pakistan, where population explosion, low per capita income, poor health facilities, poor nutrition in joint family systems, lack of education, and unhygienic communities contribute towards an increase in the incidence of malarial infections. According to the WHO, 60% of the Pakistani population lives in endemic malarial regions (3). After eradication efforts in the 1960s, malaria surged back to an epidemic level in the 1970s. An upward trend in the prevalence of malaria was partially attributed to floods that affected approximately 20 million people in over 60 districts (8). Despite a well-established malaria control program, 500,000 malaria infections and 50,000 malaria-attributable deaths occur each year in Pakistan ( 9), with approximately 37% of cases occurring in regions along the borders with Afghanistan and Iran (10).Detection of mixed infections can be difficult due to varying levels of parasitemia, low organism density, and Background/aim: The prevalences of Plasmodium falciparum and Plasmodium vivax are increasing rapidly in Pakistan, but recent data on the epidemiology of malaria are not properly reported with scarce diagnostic methods for quick diagnosis. This study was designed to determine the current prevalence and distribution of Plasmodium species in the vicinity of Rawalpindi and Islamabad and report on the validity of the immunochromatographic test (ICT) in diagnosing malarial infections.Materials and methods: A total of 1500 blood samples obtained from a local hospital were screened during the course of this study via microscopic examination and ICT.Results: It was seen that malaria was highly endemic in this region. Both P. vivax and P. falciparum were prevalent in all age groups with high seasonal variations, showing a summer peak for P. vivax and a winter peak for P. falciparum. In a comparative study of the diagnostic methods it was observed that the ICT is 95% sensitive and 100% specific for both P. falciparum and P. vivax, while microscopic study was 100% sens...

Passive Surveillance of Malaria in Pregnant Women, Non-pregnant Women and Children Under 5 Years of Age in Bannu District, Khyber Pakhtunkhwa Pakistan

“…Our study also shows a high prevalence of malaria in nonpregnant women, consistent with other studies in Pakistan ( 11), but differs from other studies (34,35). The risk factors and reasons for the gender difference could not be explained because the study participants did not provide data on actual lifestyles.…”

Prevalence of Malaria Reported during Summer and Winter at a Tertiary Care Hospital in Karachi, Pakistan

“…This is a unique finding reported from Karachi, a coastal city of Pakistan, as it shows that the frequency of malaria cases reported here are greater than those reported from cities situated in the northern part of Pakistan. 9 Hence costal proximity can be a factor in the frequency of malaria infection, along with weather. A predominance of Plasmodium vivax over Plasmodium falciparum cases was observed in this study.…”