Abstract
BackgroundMalaria remains a serious public health problem globally. As the elimination of indigenous malaria continues in China, imported malaria has gradually become a major health hazard. Well-timed and accurate diagnoses could support the timely implementation of therapeutic schedules, reveal the prevalence of imported malaria and avoid transmission of the disease.MethodsBlood samples were collected in Wuhan, China, from August 2011 to December 2018. All patients accepted microscopy and rapid diagnosis test (RDT) examinations. Subsequently, each of the positive or suspected positive cases was tested for four human-infectious Plasmodium species by using 18S rRNA-based nested PCR and Taqman probe-based real-time PCR. The results of the microscopy and the two molecular diagnostic methods were analysed. Importation origins were traced by country, and the prevalence of Plasmodium species was analysed by year.ResultsA total of 296 blood samples, including 288 that were microscopy and RDT positive, 7 RDT and Plasmodium falciparum positive, and 1 suspected case, were collected and reanalysed. After application of the two molecular methods and sequencing, 291 cases including 245 P. falciparum, 15 Plasmodium vivax, 20 Plasmodium ovale, 6 Plasmodium malariae and 5 mixed infections (3 P. falciparum + P. ovale, 2 P. vivax + P. ovale) were confirmed. These patients had returned from Africa (95.53%) and Asia (4.47%). Although the prevalence displayed a small-scale fluctuation, the overall trend of the imported cases increased yearly.ConclusionsThese results emphasize the necessity of combined utilization of the four tools for malaria diagnosis in clinic and in field surveys of potential risk regions worldwide including Wuhan.
Highlights
Malaria remains a serious public health problem globally
Microscopic examination and rapid diagnosis test (RDT) assays The blood samples were first subjected to One Step Malaria histidine-rich protein 2 (HRP2)/pLDH (P.f/Pan) (Wondfo, Guangzhou, China) detection
For the 243 microscopy-positive P. falciparum cases (Fig. 2a), parasitaemia ranged from 100 to 500,000 parasite/μl, and the mean parasite density was 88,879 parasite/μl
Summary
Malaria remains a serious public health problem globally. As the elimination of indigenous malaria continues in China, imported malaria has gradually become a major health hazard. The World Health Organization (WHO) hopes to eliminate malaria in at least 35 additional countries (based on data from 2015) by 2030 [2]. To assist in this goal, China planned to eliminate the disease by 2020 [3]. Imported malaria has gradually become a major threat in need of a process of prevention, control and elimination in endemic and nonendemic areas globally, including in China. It is worth mentioning that imported malaria cases from Africa and SE Asia have been gradually increasing yearly in China, including in the provincial capital of the Hubei province, Wuhan [4, 5]. For efficient control and in order to achieve malaria eradication before 2020 in China according to the state plan [3], imported malaria patients in China, especially in first-tier cities with a high population density and mobility, such as Wuhan, need to be quickly noticed
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