Plasma concentration of parasite DNA as a measure of disease severity in falciparum malaria.

Autor:	Imwong M; Department of Molecular Tropical Medicine and Genetics., Woodrow CJ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford., Hendriksen IC; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford., Veenemans J; Cell Biology and Immunology Group, Wageningen University Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands., Verhoef H; MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, United Kingdom Cell Biology and Immunology Group, Wageningen University MRC Keneba, the Gambia., Faiz MA; Dev Care Foundation, Dhaka, Bangladesh., Mohanty S; Department of Medicine, Ispat Hospital, Rourkela, India., Mishra S; Department of Medicine, Ispat Hospital, Rourkela, India., Mtove G; Amani Centre, National Institute for Medical Research, Muheza., Gesase S; Korogwe Research Laboratory, National Institute for Medical Research, Tanga, Tanzania., Seni A; Hospital Central da Beira., Chhaganlal KD; Hospital Central da Beira Faculty of Health Sciences, Catholic University of Mozambique, Beira, Mozambique., Day NP; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford., Dondorp AM; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford., White NJ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand Centre for Tropical Medicine, Churchill Hospital, University of Oxford.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2015 Apr 01; Vol. 211 (7), pp. 1128-33. Date of Electronic Publication: 2014 Oct 24.
DOI:	10.1093/infdis/jiu590
Abstrakt:	In malaria-endemic areas, Plasmodium falciparum parasitemia is common in apparently healthy children and severe malaria is commonly misdiagnosed in patients with incidental parasitemia. We assessed whether the plasma Plasmodium falciparum DNA concentration is a useful datum for distinguishing uncomplicated from severe malaria in African children and Asian adults. P. falciparum DNA concentrations were measured by real-time polymerase chain reaction (PCR) in 224 African children (111 with uncomplicated malaria and 113 with severe malaria) and 211 Asian adults (100 with uncomplicated malaria and 111 with severe malaria) presenting with acute falciparum malaria. The diagnostic accuracy of plasma P. falciparum DNA concentrations in identifying severe malaria was 0.834 for children and 0.788 for adults, similar to that of plasma P. falciparum HRP2 levels and substantially superior to that of parasite densities (P < .0001). The diagnostic accuracy of plasma P. falciparum DNA concentrations plus plasma P. falciparum HRP2 concentrations was significantly greater than that of plasma P. falciparum HRP2 concentrations alone (0.904 for children [P = .004] and 0.847 for adults [P = .003]). Quantitative real-time PCR measurement of parasite DNA in plasma is a useful method for diagnosing severe falciparum malaria on fresh or archived plasma samples. (© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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