Improved detection of malaria cases in island settings of Vanuatu and Kenya by PCR that targets the Plasmodium mitochondrial cytochrome c oxidase III ( cox3 ) gene

• Published in: Parasitology international Vol. 64; no. 3; pp. 304 - 308
• Main Authors: Isozumi, Rie, Fukui, Mayumi, Kaneko, Akira, Chan, Chim W, Kawamoto, Fumihiko, Kimura, Masatsugu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ireland Ltd 01.06.2015
• Subjects: cox3; DNA Primers; DNA, Protozoan; Electron Transport Complex IV - genetics; Gastroenterology and Hepatology; Genes, Mitochondrial; Human malaria; Humans; Infectious Disease; Kenya; Malaria - diagnosis; Medicin och hälsovetenskap; Mitochondrial DNA; Nested PCR; Parasitemia - diagnosis; Plasmodium; Plasmodium - genetics; Plasmodium - isolation & purification; Plasmodium falciparum - genetics; Plasmodium falciparum - isolation & purification; Plasmodium vivax - genetics; Plasmodium vivax - isolation & purification; Polymerase Chain Reaction - methods; Sensitivity and Specificity; Vanuatu; Kenya; Vanuatu; Plasmodium; cox3; Malaria diagnosis; Nested PCR; Mitochondrial DNA; Human malaria
• ISSN: 1383-5769; 1873-0329; 1873-0329
• DOI: 10.1016/j.parint.2014.09.006

Abstract Detection of sub-microscopic parasitemia is crucial for all malaria elimination programs. PCR-based methods have proven to be sensitive, but two rounds of amplification (nested PCR) are often needed to detect the presence of Plasmodium DNA. To simplify the detection process, we designed a nested PCR method whereby only the primary PCR is required for the detection of the four major human Plasmodium species. Primers designed for the detection of the fifth species, Plasmodium knowlesi , were not included in this study due to the absence of appropriate field samples. Compared to the standard 18S rDNA PCR method, our cytochrome c oxidase III ( cox3 ) method detected 10–50% more cases while maintaining high sensitivities (1.00) for all four Plasmodium species in our samples from Vanuatu (n = 77) and Kenya (n = 76). Improvement in detection efficiency was more substantial for samples with sub-microscopic parasitemia (54%) than those with observable parasitemia (10–16%). Our method will contribute to improved malaria surveillance in low endemicity settings.