Comparison of Giemsa microscopy with nested PCR for the diagnosis of malaria in North Gondar, north-west Ethiopia

Alemu, Abebe; Fuehrer, Hans‐Peter; Getnet, Gebeyaw; Kassu, Afework; Getie, Sisay; Noedl, Harald

doi:10.1186/1475-2875-13-174

Cited by 45 publications

(55 citation statements)

References 19 publications

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“…This finding is not in consonance with the good measure of agreement with nested PCR observed by Alemu et al [20]. Microscopy is subjective and the result obtained is dependent on the quality of training of the observer.…”

Section: Discussioncontrasting

confidence: 60%

Evaluation of the utility value of three diagnostic methods in the detection of malaria parasites in endemic area

Ugah¹,

Alo²,

Owolabi³

et al. 2017

Malar J

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BackgroundMalaria is a debilitating disease with high morbidity and mortality in Africa, commonly caused by different species of the genus Plasmodium in humans. Misdiagnosis is a major challenge in endemic areas because of other disease complications and technical expertise of the medical laboratory staff. Microscopic method using Giemsa-stained blood film has been the mainstay of diagnosis of malaria. However, since 1993 when rapid diagnostic test (RDT) kits were introduced, they have proved to be effective in the diagnosis of malaria. This study was aimed at comparing the accuracy of microscopy and RDTs in the diagnosis of malaria using nested PCR as the reference standard. Four hundred and twenty (420) venous blood specimens were collected from patients attending different General Hospitals in Ebonyi State with clinical symptoms of malaria. The samples were tested with Giemsa-stained microscopy and three RDTs. Fifty specimens were randomly selected for molecular analysis.ResultsUsing different diagnostic methods, the prevalence of malaria among the subjects studied was 25.95% as detected by microscopy, prevalence found among the RDTs was 22.90, 15.20 and 54.80% for Carestart, SD Bioline PF and SD Bioline PF/PV, respectively. Molecular assay yielded a prevalence of 32%. The major specie identified was Plasmodium falciparum; there was co-infection of P. falciparum with Plasmodium malariae and Plasmodium ovale. The sensitivity and specificity of microscopy was 50.00 and 70.59% while that of the RDTs were (25.00 and 85.29%), (25.00 and 94.12%) and (68.75 and 52.94%) for Carestart, SD Bioline PF and SD Bioline PF/PV, respectively. Cohen’s kappa coefficient was used to measure the level of agreement of the methods with nested PCR. Microscopy showed a moderate measure of agreement (k = 0.491), Carestart showed a good measure of agreement (k = 0.611), SD Bioline PF showed a fair measure of agreement (k = 0.226) while SD Bioline PF/PV showed a poor measure of agreement (k = 0.172).ConclusionsThis study recommends that the policy of malaria diagnosis be changed such that the routine diagnosis of malaria is done by a combination of both microscopy and a RDT kit of high sensitivity and specificity so as to complement the errors associated with either of the methods. The finding of P. ovale in the study area necessitates an expanded molecular epidemiology of malaria within the study area.

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Section: Discussioncontrasting

confidence: 60%

Evaluation of the utility value of three diagnostic methods in the detection of malaria parasites in endemic area

Ugah¹,

Alo²,

Owolabi³

et al. 2017

Malar J

View full text Add to dashboard Cite

show abstract

“…Our results are in tandem agreement with previous studies showing that molecular detection techniques have greater sensitivity and specificity than either microscopy for the identification of single and mixed species infections [23,[39][40][41][42], as well as sub-microscopic infections [11,43]. The detection of Plasmodium parasites at very low density parasitaemia is difficult by microscopy and thus requires a molecular approach especially for surveillance or epidemiological studies [44]. Current methods which rely on PCR-based assays of ribosomal RNA genes to detect circulating parasites have been suggested to represent the overall gold standard of malaria diagnostics [45], and is increasingly used in epidemiological studies.…”

Section: Discussionsupporting

confidence: 82%

Molecular investigation of sub-microscopic and mixed Plasmodium species infection in North-Central Nigeria

Oyedeji¹,

Awobode²,

Bassi³

2017

APJTD

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“…Polymerase chain reaction (PCR) in its various formats has emerged as the most sensitive method able to detect low levels of parasites in the blood especially in this setting [36, 37]. However, PCR requires high capital investment costs, service agreements, reagent supplies, and trained staff in molecular technologies with robust quality assurance programmes.…”

Section: Discussionmentioning

confidence: 99%

Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia

Tegegne

Getie

Lemma

et al. 2017

Malar J

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Background: Malaria is a major public health problem and an important cause of maternal and infant morbidity in sub-Saharan Africa, including Ethiopia. Early and accurate diagnosis of malaria with effective treatment is the best strategy for prevention and control of complications during pregnancy and infant morbidity and mortality. However, laboratory diagnosis has relied on the identification of malaria parasites and parasite antigens in peripheral blood using Giemsa-stained microscopy or rapid diagnostic tests (RDTs) which lack analytical and clinical sensitivity. The aim of this study was to evaluate the performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia. Methods:A cross sectional study was conducted from January to April 2016. Pregnant women (n = 87) suspected of having malaria at six health centres were enrolled. A venous blood sample was collected from each study subject, and analysed for Plasmodium parasites by microscopy, RDT, and LAMP. Diagnostic accuracy outcome measures (sensitivity, specificity, predictive values, and Kappa scores) of microscopy, RDT and LAMP were compared to nested polymerase chain reaction (nPCR) as the gold standard. Specimen processing and reporting times were documented.Results: Using nPCR as the gold standard technique, the sensitivity of microscopy and RDT was 90 and 70%, and the specificity was 98.7 and 97.4%, respectively. LAMP assay was 100% sensitive and 93.5% specific compared to nPCR. Conclusions:This study showed higher sensitivity of LAMP compared to microscopy and RDT for the detection of malaria in pregnancy. Increased sensitivity and ease of use with LAMP in point-of-care testing for malaria in pregnancy was noted. LAMP warrants further evaluation in intermittent screening and treatment programmes in pregnancy.

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Comparison of Giemsa microscopy with nested PCR for the diagnosis of malaria in North Gondar, north-west Ethiopia

Cited by 45 publications

References 19 publications

Evaluation of the utility value of three diagnostic methods in the detection of malaria parasites in endemic area

Evaluation of the utility value of three diagnostic methods in the detection of malaria parasites in endemic area

Molecular investigation of sub-microscopic and mixed Plasmodium species infection in North-Central Nigeria

Performance of loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria among malaria suspected pregnant women in Northwest Ethiopia

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