† These authors contributed equally to this study.
MULTIPLEX DETECTION OF MALARIA AND FILARIASIS PARASITESP. vivax , P. malariae , and P. ovale , 25 and W. bancrofti in a sequence-specific manner. The PCR reagents and conditions for Plasmodium spp. amplification have been described. 24,25 For the multiplex PCR, we evaluated the dNTP concentrations (dATP, dTTP, dGTP, and dCTP) from 200 μM to 800 μM to ensure nucleotide availability for the amplification of both Plasmodium spp. and W. bancrofti genomic regions, and added 0.12 μM of each of W. bancrofti UP (5¢-GATGGTGTATAATAGCAGCA-3¢) and W. bancrofti DN (5¢-GTCATTTATTTCTCCGTCGACTGTC-3¢) amplification primers to the PCR master mixture. The dNTP concentration that performed with consistently high efficiency was 400 μM. The PCR products were subjected to electrophoresis on agarose gels to visualize distinct Plasmodium spp. (491-500 basepairs) 25 and W. bancrofti (174 basepairs) amplicons. The PCR products were then subjected to LDR-FMA as described, 25 with minor modifications that included use of LDR primers: a W. bancrofti -specific primer (tacactttatcaaatcttacaatcTATATCTGCCCATAGAAATAACTA [sequence in lower case letters represents a 24-basepair oligonucleotide tag]) and a W. bancrofti common primer (Phos 5¢-CGGTGGATCTCTGGTTATCACTCTG-3¢Biotin). In the LDR-fluorescent microsphere hybridization solution containing Plasmodium species-specific fluorescent microspheres, 25 we added W. bancrofti -specific fluorescent micro sphere #3. Our W. bancrofti PCR and LDR primer sequences are based on the W. bancrofti sequence in GenBank (accession no. AY297458).
18To confirm the specificity of our W. bancrofti PCR primers, we amplified an approximately 170-basepair genomic DNA region from one microfilaria isolated from a person in Papua New Guinea and sequenced it. We also sequenced the PCR products from two microfilaria-positive persons from Papua New Guinea whose blood samples were collected as a part of ongoing studies.32 Furthermore, we sequenced the PCR product from five pooled third-stage larvae dissected from mosquitoes that were collected in the Dreikikir District (East Sepik Province, Papua New Guinea), where malaria and lymphatic filariasis are endemic. 24,[29][30][31] All sequences were 100% identical with the W. bancrofti sequence in GenBank (accession no. AY297458).The specificity of the assay was further demonstrated by using P. falciparum , P. vivax , P. malariae , and P. ovale , and W. bancrofti genomic DNA samples ( Figure 1 ). Using these genomic DNA samples individually in LDR-FMA reactions containing primers and microspheres for all five species, we found that the assay detected only the parasite species DNA present, and background signals for all other species DNAs were below a median fluorescence intensity of 500. We then performed multiplex PCR LDR-FMA diagnosis to detect Plasmodium spp. and W. bancrofti infections in the blood samples from 517 persons living in the Dreikikir District (East Sepik Province, Papua New Guinea).Using this assay, we found that 44...