Abstract
BackgroundThe objective of this study to detect Plasmodium and a subspecies of Plasmodium using filter paper in malaria endemic province, Sanliurfa, in Turkey, compare the results of nested PCR (nPCR) with microscopy for the diagnosis of malaria and present the epidemiological data of malaria.MethodsThis study was carried out in malaria-endemic Sanliurfa between 2008 and 2011. Finger prick blood samples, thick and thin Giemsa-stained blood smears, were collected from 153 malaria-suspected farmworkers. The Giemsa-stained blood smears were examined microscopically. The obtained DNA products, extracted from blood-spotted filter papers or from the thick blood smears, were analysed by nPCR to amplify the 18S ssrRNA Plasmodium gene with genus and specific primers. The results of the microscopy were compared to the nPCR results.ResultsOf the specimens, 7.2 % were determined as Plasmodium-positive by microscopy, whereas 9.8 % were determined as Plasmodium-positive by nPCR. Of the positive Plasmodium specimens, 93.33 % were identified as P. vivax. Four out of the 15 specimens that were microscopically diagnosed as negative were Plasmodium-positive with nPCR. When compared to the microscopy, the sensitivity, specificity, and positive predictive values of the nPCR were determined as 100, 97.2 and 73.3 %, respectively. nPCR was determined to be more sensitive and specific than microscopy.ConclusionsThis study revealed that the accurate diagnosis of malaria by nPCR was compulsory in malaria-endemic Sanliurfa and nPCR should be applied routinely in laboratory studies.
Highlights
The objective of this study to detect Plasmodium and a subspecies of Plasmodium using filter paper in malaria endemic province, Sanliurfa, in Turkey, compare the results of nested PCR with microscopy for the diagnosis of malaria and present the epidemiological data of malaria
Plasmodium vivax is the only agent of indigenous malaria cases and only imported Plasmodium falciparum cases are seen in Turkey [13,14,15,16]
Treatment and elimination of the malaria symptoms confirmed the accuracy of the nested PCR (nPCR) that we found superior to microscopy
Summary
The objective of this study to detect Plasmodium and a subspecies of Plasmodium using filter paper in malaria endemic province, Sanliurfa, in Turkey, compare the results of nested PCR (nPCR) with microscopy for the diagnosis of malaria and present the epidemiological data of malaria. According to Health Ministry data, it was estimated that 89 % of 36,842 malaria cases were detected in the GAP of Turkey [11]. The GAP is one of the relatively less developed regions of the country, comprising nine administrative provinces (Adiyaman, Batman, Diyarbakır, Gaziantep, Kilis, Mardin, Siirt, Sanliurfa, and Sirnak) in the basins of the Euphrates and Tigris, and in Upper Mesopotamia. In this region, improper or excessive use of irrigation channels and deficiency in irrigation water management lead to puddles and standing water near fields. Sanliurfa is located on the board with Syria where a large influx of displaced persons from neighbouring countries
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