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Rapid immunochromatography-based detection of mixed-species malaria infection in Pakistan.
Southeast Asian J Trop Med Public Health. 2005 May; 36(3):562-4.SA

Abstract

We report the identification of mixed Plasmodium infections in four recent patients with malaria clinically refractory to empiric chloroquine therapy using the rapid antigen detection kit, NOW ICT Malaria Pf/Pv. A rapid in vitro immunodiagnostic test, the NOW ICT Malaria Pf/Pv test kit was used for the detection of circulating Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) antigens in whole blood. Peripheral blood microscopy confirmed mixed-species infection in all the cases. Thick and thin peripheral blood films were made and stained with Giemsa stain and examined by both hospital laboratory staff and an experienced parasitologist who was blinded to the results of the rapid malarial antigen tests. Four recent patients (all male; mean age, 24 years) with mixed malarial infection were identified. All the subjects were males working for an oil company in a coastal area of Pakistan, and all had been diagnosed presumptively with malaria based on clinical grounds (without microbiologic confirmation), and were treated empirically with chloroquine without clinical response. Semiquantitative malaria counts via microscopy were as follows: P. vivax, scanty (2 patients) and moderate (2 patients); for P. falciparum--scanty (1 patient), moderate (2 patients), and heavy (1 patient). The present case series, although limited by the small number of patients with proven mixed P. falciparum-P. vivax infection, highlights the usefulness of the rapid antigen test in a highly malarious region of Pakistan where chloroquine resistance is prevalent. Although there was full concordance between the results of blood smear microscopy and rapid antigen testing, these techniques are potentially most useful when there is a discrepancy with microscopy findings. Accurate and rapid diagnosis of parasites, particularly in cases of mixed P. falciparum and P. vivax infection, is of immense importance for individual patient management and in reducing the burden of disease, especially in regions of chloroquine resistance.

Authors+Show Affiliations

Beg MA
Department of Pathology and Microbiology, The Aga Khan University, PO Box 3500, Stadium Road, Karachi, Pakistan. masim.beg@aku.edu
Ali SS
No affiliation info available
Haqqee R
No affiliation info available
Khan MA
No affiliation info available
Qasim Z
No affiliation info available
Hussain R
No affiliation info available
Smego RA
No affiliation info available

MeSH

AdultAnimalsAntigens, ProtozoanAntimalarialsAzure StainsChloroquineChromatographyDrug ResistanceHumansMalaria, FalciparumMalaria, VivaxMalePakistanPlasmodium falciparumPlasmodium vivaxReagent Kits, DiagnosticRetrospective StudiesSerologic Tests

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16124417

Citation

Beg, M A., et al. "Rapid Immunochromatography-based Detection of Mixed-species Malaria Infection in Pakistan." The Southeast Asian Journal of Tropical Medicine and Public Health, vol. 36, no. 3, 2005, pp. 562-4.
Beg MA, Ali SS, Haqqee R, et al. Rapid immunochromatography-based detection of mixed-species malaria infection in Pakistan. Southeast Asian J Trop Med Public Health. 2005;36(3):562-4.
Beg, M. A., Ali, S. S., Haqqee, R., Khan, M. A., Qasim, Z., Hussain, R., & Smego, R. A. (2005). Rapid immunochromatography-based detection of mixed-species malaria infection in Pakistan. The Southeast Asian Journal of Tropical Medicine and Public Health, 36(3), 562-4.
Beg MA, et al. Rapid Immunochromatography-based Detection of Mixed-species Malaria Infection in Pakistan. Southeast Asian J Trop Med Public Health. 2005;36(3):562-4. PubMed PMID: 16124417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid immunochromatography-based detection of mixed-species malaria infection in Pakistan. AU - Beg,M A, AU - Ali,S S, AU - Haqqee,R, AU - Khan,M A, AU - Qasim,Z, AU - Hussain,R, AU - Smego,R A,Jr PY - 2005/8/30/pubmed PY - 2006/11/4/medline PY - 2005/8/30/entrez SP - 562 EP - 4 JF - The Southeast Asian journal of tropical medicine and public health JO - Southeast Asian J Trop Med Public Health VL - 36 IS - 3 N2 - We report the identification of mixed Plasmodium infections in four recent patients with malaria clinically refractory to empiric chloroquine therapy using the rapid antigen detection kit, NOW ICT Malaria Pf/Pv. A rapid in vitro immunodiagnostic test, the NOW ICT Malaria Pf/Pv test kit was used for the detection of circulating Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) antigens in whole blood. Peripheral blood microscopy confirmed mixed-species infection in all the cases. Thick and thin peripheral blood films were made and stained with Giemsa stain and examined by both hospital laboratory staff and an experienced parasitologist who was blinded to the results of the rapid malarial antigen tests. Four recent patients (all male; mean age, 24 years) with mixed malarial infection were identified. All the subjects were males working for an oil company in a coastal area of Pakistan, and all had been diagnosed presumptively with malaria based on clinical grounds (without microbiologic confirmation), and were treated empirically with chloroquine without clinical response. Semiquantitative malaria counts via microscopy were as follows: P. vivax, scanty (2 patients) and moderate (2 patients); for P. falciparum--scanty (1 patient), moderate (2 patients), and heavy (1 patient). The present case series, although limited by the small number of patients with proven mixed P. falciparum-P. vivax infection, highlights the usefulness of the rapid antigen test in a highly malarious region of Pakistan where chloroquine resistance is prevalent. Although there was full concordance between the results of blood smear microscopy and rapid antigen testing, these techniques are potentially most useful when there is a discrepancy with microscopy findings. Accurate and rapid diagnosis of parasites, particularly in cases of mixed P. falciparum and P. vivax infection, is of immense importance for individual patient management and in reducing the burden of disease, especially in regions of chloroquine resistance. SN - 0125-1562 UR - https://www.unboundmedicine.com/medline/citation/16124417/Rapid_immunochromatography_based_detection_of_mixed_species_malaria_infection_in_Pakistan_ DB - PRIME DP - Unbound Medicine ER -