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Journal of Clinical Microbiology, May 1999, p. 1269-1273, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Detection and Species Determination of Malaria Parasites by PCR: Comparison with Microscopy and with ParaSight-F and ICT Malaria Pf Tests in a Clinical Environment

Jill M. Tham,1,2,* Szu Hee Lee,3 Theresa M. C. Tan,1,dagger Robert C. Y. Ting,1 and Ursula A. K. Kara2

Institute of Molecular and Cell Biology, Singapore 117609,1 Division of Haematology, National University Hospital, Singapore 119074,3 and Molecular Parasitology Laboratory, Department of Biological Sciences, National University of Singapore, Singapore 1192602

Received 21 September 1998/Returned for modification 7 December 1998/Accepted 26 January 1999

A rapid procedure for the diagnosis of malaria infections directly from dried blood spots by PCR amplification was evaluated with samples from 52 patients. Plasmodium infections were identified with a genus-specific primer set, and species differentiation between Plasmodium falciparum and Plasmodium vivax was analyzed by multiplex PCR. The PCR test with any of the three primer sets was able to detect as few as four parasites per microliter by gel electrophoresis or by nonisotopic paper hybridization chromatography. The diagnoses obtained by PCR correlated closely with those obtained by Giemsa staining except for two samples observed to have mixed P. falciparum-P. vivax infections. These were initially missed by microscopic analysis. In comparison with antigen-capture assays for P. falciparum, the PCR assays were able to detect three infections that were missed by the ParaSight-F test. The PCR test was negative for nine ParaSight-F-positive samples and one ICT Malaria Pf-positive sample, and these were confirmed to be false-positive results. The PCR thus gave no false-negative or false-positive results. Patients undergoing antimalarial therapy were also monitored by the PCR assay. Four of seven patients who were PCR positive for P. vivax at the time of discharge were later readmitted to the hospital with a recurrence of P. vivax infection. We would like to propose that PCR is a sensitive and easy method that can serve as a useful addition to microscopy for the diagnosis and the clinical monitoring of treatment of malaria.

* Corresponding author. Mailing address: Molecular Parasitology Laboratory, Department of Biological Sciences, National University of Singapore, 10 Kent Ridge Crescent, Singapore 119260. Phone: (65) 874-7834. Fax: (65) 779-2486. E-mail: mcbthamj{at}imcb.nus.edu.sg.

dagger Present address: Department of Biochemistry, National University of Singapore, Singapore 119260.

Journal of Clinical Microbiology, May 1999, p. 1269-1273, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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