Usefulness of Seminested Multiplex PCR in Surveillance of Imported Malaria in Spain

ABSTRACT The use of a new PCR-based method for the diagnosis of malaria in the Spanish Malaria Reference Laboratory has promoted an increase in confirmed cases of malaria. From August 1997 to July 1998, a total of 192 whole-blood samples and 71 serum samples from 168 patients were received from the hospitals of the Spanish National Health System. Most of the patients came from west-central African countries (85%). This molecular method showed more sensitivity and specificity than microscopy, detecting 12.4% more positive samples than microscopy and 13% of mixed infections undetectable by Giemsa stain. Plasmodium falciparum was the main species detected, with 68% of the total positive malaria cases, followed by Plasmodium malariae(29%), Plasmodium vivax (14%), and Plasmodium ovale (7%), including mixed infections in all cases. This report consists of the first wide, centralized survey of malaria surveillance in Spain. The reference laboratory conducted the analysis of all imported cases in order to detect trends in acquisition. The use of a seminested multiplex PCR permitted confirmation of the origins of the infections and the Plasmodium species involved and confirmation of the effectiveness of drug treatments. This PCR also allowed the detection of the presence in Spain of primaquine-tolerantP. vivax strains from west-central Africa, as well as the detection of a P. falciparum infection induced by transfusion.

[1]  J. M. Rubio,et al.  Semi-nested, multiplex polymerase chain reaction for detection of human malaria parasites and evidence of Plasmodium vivax infection in Equatorial Guinea. , 1999, The American journal of tropical medicine and hygiene.

[2]  G. Sabatinelli,et al.  Malaria in Maremma, Italy , 1998, The Lancet.

[3]  D. Bradley,et al.  Malaria imported into the United Kingdom in 1996. , 1998, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[4]  P. Chiodini,et al.  Evaluation of a Malaria Antibody ELISA and Its Value in Reducing Potential Wastage of Red Cell Donations from Blood Donors Exposed to Malaria, with a Note on a Case of Transfusion‐Transmitted Malaria , 1997, Vox sanguinis.

[5]  J. K. Nayar,et al.  Studies on a primaquine-tolerant strain of Plasmodium vivax from Brazil in Aotus and Saimiri monkeys. , 1997, The Journal of parasitology.

[6]  G. Sabatinelli,et al.  Prevention and morbidity of malaria in non-immune subjects; a case-control study among Italian troops in Somalia and Mozambique, 1992-1994. , 1997, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[7]  K. Kain,et al.  Plasmodium vivax infections in U.S. Army troops: failure of primaquine to prevent relapse in studies from Somalia. , 1997, The American journal of tropical medicine and hygiene.

[8]  V. Sharma,et al.  Studies on Plasmodium vivax relapse pattern in Kheda district, Gujarat. , 1996, Indian journal of malariology.

[9]  F. Castelli,et al.  Short report: primaquine-tolerant Plasmodium vivax in an Italian traveler from Guatemala. , 1996, The American journal of tropical medicine and hygiene.

[10]  W E Collins,et al.  Primaquine resistance in Plasmodium vivax. , 1996, The American journal of tropical medicine and hygiene.

[11]  G. Snounou,et al.  Detection of malaria in Malaysia by nested polymerase chain reaction amplification of dried blood spots on filter papers. , 1996, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[12]  T. Schall,et al.  Mutations in the erythrocyte chemokine receptor (Duffy) gene: the molecular basis of the Fya/Fyb antigens and identification of a deletion in the Duffy gene of an apparently healthy individual with the Fy(a – b–) phenotype , 1995, British journal of haematology.

[13]  T. T. Vu,et al.  Screening donor blood for malaria by polymerase chain reaction. , 1995, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[14]  S. Pukrittayakamee,et al.  Blood stage antimalarial efficacy of primaquine in Plasmodium vivax malaria. , 1994, The Journal of infectious diseases.

[15]  G. Snounou,et al.  The importance of sensitive detection of malaria parasites in the human and insect hosts in epidemiological studies, as shown by the analysis of field samples from Guinea Bissau. , 1993, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[16]  W. Jarra,et al.  Identification of the four human malaria parasite species in field samples by the polymerase chain reaction and detection of a high prevalence of mixed infections. , 1993, Molecular and biochemical parasitology.

[17]  World malaria situation in 1991. , 1993, Canada communicable disease report = Releve des maladies transmissibles au Canada.

[18]  R Higuchi,et al.  Chelex 100 as a medium for simple extraction of DNA for PCR-based typing from forensic material. , 2013, BioTechniques.

[19]  K. Kain,et al.  Determination of genetic variation within Plasmodium falciparum by using enzymatically amplified DNA from filter paper disks impregnated with whole blood , 1991, Journal of clinical microbiology.

[20]  T. McCutchan,et al.  Ribosomal RNA-based diagnosis of Plasmodium falciparum malaria. , 1989, Molecular and biochemical parasitology.

[21]  T. McCutchan,et al.  RAPID, SENSITIVE DIAGNOSIS OF MALARIA BASED ON RIBOSOMAL RNA , 1989, The Lancet.

[22]  D. Clyde,et al.  Radical cure of Chesson strain vivax malaria in man by 7, not 14, days of treatment with primaquine. , 1977, The American journal of tropical medicine and hygiene.

[23]  L. Miller,et al.  The resistance factor to Plasmodium vivax in blacks. The Duffy-blood-group genotype, FyFy. , 1976, The New England journal of medicine.