Plasma concentration of parasite DNA as a measure of disease severity in falciparum malaria.


Imwong, M; Woodrow, CJ; Hendriksen, IC; Veenemans, J; Verhoef, H; Faiz, MA; Mohanty, S; Mishra, S; Mtove, G; Gesase, S; Seni, A; Chhaganlal, KD; Day, NP; Dondorp, AM; White, NJ; (2014) Plasma concentration of parasite DNA as a measure of disease severity in falciparum malaria. The Journal of infectious diseases. ISSN 0022-1899 DOI: 10.1093/infdis/jiu590

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Abstract

In endemic areas malaria parasitemia is common in apparently healthy children and severe malaria is commonly misdiagnosed in patients with incidental parasitemia. We assessed the performance of plasma P. falciparum DNA concentration measurement in distinguishing uncomplicated from severe malaria in African children and Asian adults. P. falciparum DNA concentrations were measured by real-time PCR in 224 African children (111 uncomplicated, 113 severe) and 211 Asian adults (100 uncomplicated, 111 severe) presenting with acute falciparum malaria. The diagnostic accuracy of plasma PfDNA concentrations in identifying severe malaria was 0.834 in children and 0.788 in adults, similar to that of plasma PfHRP2, and substantially superior to parasite density (p<0.0001). Combining measurement of plasma PfDNA with PfHRP2 concentrations improved diagnostic accuracy significantly (children: 0.904, p=0.004; adults: 0.847, p=0.003). Quantitative real-time PCR measurement of parasite DNA in plasma is a useful method for diagnosing severe falciparum malaria on fresh or archived plasma samples.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Malaria Centre
PubMed ID: 25344520
Web of Science ID: 354697500014
URI: http://researchonline.lshtm.ac.uk/id/eprint/2017866

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