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      Distribution of Plasmodium species on the island of Grande Comore on the basis of DNA extracted from rapid diagnostic tests Translated title: La distribution des espèces de Plasmodium dans l’île de Grande Comore, à partir de l’ADN extrait des tests de diagnostic rapide

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          In the Union of Comoros, interventions for combating malaria have contributed to a spectacular decrease in the prevalence of the disease. We studied the current distribution of Plasmodium species on the island of Grande Comore using nested PCR. The rapid diagnostic tests (RDTs) currently used in the Comoros are able to identify Plasmodium falciparum but no other Plasmodium species. In this study, we tested 211 RDTs (158 positive and 53 negative). Among the 158 positive RDTs, 22 were positive for HRP2, 3 were positive only for pLDH, and 133 were positive for HRP2 and pLDH. DNA was extracted from a proximal part of the nitrocellulose membrane of RDTs. A total of 159 samples were positive by nested PCR. Of those, 156 (98.11%) were positive for P. falciparum, 2 (1.25%) were positive for P. vivaxI, and 1 (0.62%) was positive for P. malariae. None of the samples were positive for P. ovale. Our results show that P. falciparum is still the most dominant species on the island of Grande Comore, but P. vivax and P. malariae are present at a low prevalence.

          Translated abstract

          Dans l’Union des Comores, des interventions pour la lutte contre le paludisme ont contribué à une diminution spectaculaire de la prévalence de la maladie. Nous avons étudié la répartition actuelle des espèces de Plasmodium sur l’île de Grande Comore par PCR imbriquée. Les tests de diagnostic rapide (TDRs) actuellement utilisés aux Comores sont en mesure d’identifier Plasmodium falciparum, mais pas d’autres espèces de Plasmodium. Dans cette étude, nous avons testé 211 TDRs (158 positifs et 53 négatifs). Parmi les 158 TDRs positifs, 22 étaient positifs pour HRP2, 3 étaient positifs seulement pour pLDH et 133 étaient positifs pour à HRP2 et pLDH. L’ADN a été extrait d’une partie proximale de la membrane de nitrocellulose des TDRs. Au total, 159 échantillons étaient positifs par PCR nichée. Parmi eux, 156 (98,11 %) étaient positifs pour P. falciparum, 2 (1,25 %) étaient positifs pour P. vivax et 1 (0,62 %) était positif pour P. malariae. Aucun des échantillons n’était positif pour P. ovale. Nos résultats montrent que P. falciparum est toujours l’espèce dominante dans l’île de Grande Comore, mais P. vivax et P. malariae sont présents à une faible prévalence.

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          Most cited references 14

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          A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies.

          A nested polymerase chain reaction (PCR) assay that uses Plasmodium genus-specific primers for the initial PCR (nest 1) amplification and either genus- or species-specific primers for the nest 2 amplifications was tested on laboratory and field samples. With in vitro cultured Plasmodium falciparum-infected blood samples, it was capable of detecting six parasites/microl of blood using DNA prepared from 25-microl blood spots on filter paper. The assay was evaluated on fingerprick blood samples collected on filter paper from 129 individuals living in a malaria-endemic area in Malaysia. Malaria prevalence by genus-specific nested PCR was 35.6% (46 of 129) compared with 28.7% (37 of 129) by microscopy. The nested PCR detected seven more malaria samples than microscopy in the first round of microscopic examination, malaria in three microscopically negative samples, six double infections identified as single infections by microscopy and one triple infection identified as a double infection by microscopy. The nested PCR assay described is a sensitive technique for collecting accurate malaria epidemiologic data. When coupled with simple blood spot sampling, it is particularly useful for screening communities in remote regions of the world.
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            Update on rapid diagnostic testing for malaria.

            To help mitigate the expanding global impact of malaria, with its associated increasing drug resistance, implementation of prompt and accurate diagnosis is needed. Malaria is diagnosed predominantly by using clinical criteria, with microscopy as the current gold standard for detecting parasitemia, even though it is clearly inadequate in many health care settings. Rapid diagnostic tests (RDTs) have been recognized as an ideal method for diagnosing infectious diseases, including malaria, in recent years. There have been a number of RDTs developed and evaluated widely for malaria diagnosis, but a number of issues related to these products have arisen. This review highlights RDTs, including challenges in assessing their performance, internationally available RDTs, their effectiveness in various health care settings, and the selection of RDTs for different health care systems.
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              Rapid diagnostic testing for malaria.

              Malaria rapid diagnostic devices (MRDD) have been developed with the hope that they would offer accurate, reliable, rapid, cheap and easily available alternatives to traditional methods of malaria diagnosis. The results from early malaria rapid diagnostic studies were quite promising, especially for detecting Plasmodium falciparum at densities of more than 100-500 parasites/microl. Despite the introduction of these devices over a decade ago, only a few target antigens have been introduced. Of greater concern, these devices have shown limitations in sensitivity, ability to differentiate species and robustness under field conditions in the tropics. Recent trials have revealed wide variability in sensitivity both within and between products. We review the recent trials assessing MRDD use for the diagnosis of P. falciparum and non-P. falciparum infections in endemic and non-endemic countries and describe the various aspects of these devices which need further improvement. High quality, accurate, rapid and affordable diagnostic tools are urgently needed now that new antimalarial regimens, characterized by higher cost and increased toxicity, have been introduced more widely in response to emerging multi-drug resistance.

                Author and article information

                EDP Sciences
                26 August 2016
                : 23
                : ( publisher-idID: parasite/2016/01 )
                [1 ] Laboratory of Bacteriology-Virology, Hospital Aristide le Dantec Dakar BP 7325 Senegal
                [2 ] Laboratory of National Malaria Control Program Moroni Comoros
                [3 ] Laboratory of Parasitology and Mycology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University BP 5005 Dakar Senegal
                [4 ] Faculty of Science and Technology, Department of Animal Biology, Cheikh Anta Diop University Dakar Senegal
                Author notes
                [* ]Corresponding author: npapamze@ 123456gmail.com
                parasite160017 10.1051/parasite/2016034
                © N. Papa Mze et al., published by EDP Sciences, 2016

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 21, Pages: 5
                Research Article

                rdt, plasmodium species, nested pcr, malaria, comoros


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