DETECTION AND GENETIC ANALYSIS OF IMPORTED MALARIA IN EGYPT | ||||
Al-Azhar International Medical Journal | ||||
Article 5, Volume 1, Issue 7, July 2020, Page 25-29 PDF (372.33 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/aimj.2020.22391.1075 | ||||
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Authors | ||||
Hossam eldine Ahmed Romeh 1; Khairy Abdelhameed2; Ayman El-Badry3; Mohamed Abd Elrehem4; Anwar Abo_Hashim5 | ||||
1Parasitology, Faculty of Medicine, Al-Azhar University. Assiut | ||||
2Parasitology Department, Al-Azhar University | ||||
3Department of Parasitology, Kasar Al-Ainy Faculty of Medicine, Cairo University, Egypt. Department of Microbiology - Medical Parasitology Section, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia | ||||
4Department of Parasitology, Faculty of Medicine, Al-Azhar University, Assuit, Egypt. | ||||
51Department of Parasitology, Faculty of Medicine, Al-Azhar University, Cairo,Egypt | ||||
Abstract | ||||
DETECTION AND GENETIC ANALYSIS OF IMPORTED MALARIA IN EGYPT ABSTRACT Background: Microscopy consider the gold standard test for diagnosis of malaria although application of it is limited to use to highly experienced microscopists. Serological tests and nPCR is providing efficient diagnostic tests and applied for malaria diagnosis and research. The work aim: The work aim is detection and genetic analysis of imported malaria in Egypt. Patients and method:This study is a cross section one.750 patients’ blood samples were collected from different laboratories in Egypt from persons travel to African endemic areas coming to Egypt within previous 8 weeks; in the period from August 2017 to August 2018. All samples were examined microscopically, immunologically by(RDT) and 21positive cases examined by nPCR as a confirmatory test and for detection of parasite genotype. Results:Plasmodium species were identified microscopically in27(3.6%) out of750 individuals, 13of them were diagnosed as Pl.falciparum,7 were Pl.vivax, one was Pl.ovale and6 were mixed infection with Pl.falciparum and Pl.vivax. nPCR for species identification were performed for 21cases positive by first step PCR. 12cases were Pl.falciparum; 5cases were Pl.vivax and 4were mixed Pl.falciparum and Pl.vivax infections. The result of nPCR was exactly identical to the microscopic result. Conclusion:the major two species of malaria imported to Egypt were P.vivax and P.falciparum. Detection of species of malaria microscopically stills the gold standard test.Using nested PCR tests for diagnosis of malaria and its species is highly accurate, sensitive and specific, and able to detect species of malaria. | ||||
Keywords | ||||
Malaria; Imported; Genetic analysis; Egypt | ||||
Full Text | ||||
Malaria is a disease that affects about 3.4 million persons1 of which 2.57 million and 2.5 million are at risk for P.falciparum and P.vivax respectively while P.ovale and P.malariae have a small percentage.2 Screening of malaria is necessary to detect hot areas of malaria infection where control measures are not effective11. So, the present work aimed to screen imported malaria in Egypt. bidirectional DNA sequencing of each purified positive nPCR product was performed. | ||||
References | ||||
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Malaria indicator survey 2009, South Sudan: baseline results at the household level. Malar J, 2014; 13:45. 18. Kamel MM, Attia SS, Emam GD, AlSherbiny NA. The validity of rapid malaria tests and microscopy in detecting malaria in a pre-elimination region of Egypt. Scientifica 2016; 2016:4048032. 19. Thongdee P, Chaijaroenkul W, Kuesap J, Na-Bangchang K. Nested-PCR, and a New ELISA-Based Nova Lisa Test Kit for Malaria Diagnosis in an Endemic Area of Thailand. Korean J Parasitol, 2014; 52(4):377-81. 20. Li Z, Zhang Q, Zheng C, Zhou S, and Sun Jet al. Epidemiologic features of overseas imported malaria in the People’s Republic of China. Malar J, 2016; 15:141. 29 DISCUSSION Due to a lack of awareness of clinical manifestations and methods of diagnosis of malaria among private clinics and primary health care units due to low endemicity of malaria in Egypt. Added to this, traveling of large numbers of Egyptians to malaria-endemic countries for working and other different causes. So the aim of this work was the detection of as well as genetic analysis of imported malaria in Egypt based on clinical and laboratory assessment, through the examination of 750 blood samples of suspicious malaria-infected people coming from endemic African countries using thick and thin blood film techniques, RDT for screening and Nested PCR as a confirmatory test and genetic analysis. In the present work, it was found that out of 750 malaria suspicious patients coming from endemic countries 27(3.6%) were infected. History of fever was found in all +ve cases and this corresponding to deferent universal malaria screening research studies 16. All positive patients gave a history of travel to one of the following 11 African countries mentioned in Table 4. Most of them had a history of traveling to Sudan. Diagnosis of Plasmodium species using microscopic examination is still the gold standard method for laboratory diagnosis 17. In the present work, P. falciparum and P. vivax were the two major imported malaria species. The presence of one more positive case as detected by RDT means the presence of antigenemia without parasitemia due to the particles of the parasite my still in the blood for some time after cure, so it's difficult to detect active infection from recent infection clearance. In another study, 2 cases were RDT positive but not detected microscopically due to low parasitemia or presence of malaria antigen in blood after drug intake and blood clearance of parasite 18. The result of nPCR was identical to the microscopic results. So results of the nPCR in our study revealed a very good confirmatory diagnostic test and with specificity and sensitivity 100% in the detection of P. falciparum and P. vivax. Another research in Thailand was performed using nPCR to detect malaria species, its result also approaches 100%19. A Chinese study was performed on 1420 cases to detect imported malaria. P. falciparum was detected in 723 cases (50.9 %) and P. vivax in 629 cases (44.3 %). P. falciparum and P. vivax were the 2 major species, with 58.9 % of cases coming from Africa and 39.4% coming from Southeast Asia 20. CONCLUSION The two major malaria species in patients coming from Africa in our study were P. falciparum and P. vivax. Despite microscopic examination of Giemsa stained blood films is considered the gold standard method for laboratory diagnosis of malaria, nPCR was a very good confirmatory diagnostic test with 100% specificity and sensitivity RDT is less specific and sensitive than nPCR, but it is rapid, simple, and lower in cost compared to nPCR. So it can be used for screening of blood in blood bank and screening of endemic areas to detect infected cases and carriers. CONFLICT OF INTEREST The authors declare that they have no conflict of interest | ||||
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