Malaria screening: what is the contribution of molecular biology?

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Published Jul 28, 2024
https://doi.org/10.62438/tunismed.v102i8.4949
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Vol. 102 No. 8 (2024): Tunis Med aug 2024

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Sameh Belgacem
Microbiology Laboratory, Fattouma Bourguiba University Hospital, Monastir. Parasitology - Medical and Molecular Mycology Research Laboratory (LR12ES08), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia.
Mohamed Bettaieb
Parasitology - Medical and Molecular Mycology Research Laboratory (LR12ES08), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia.
Najoua Houas
Parasitology - Medical and Molecular Mycology Research Laboratory (LR12ES08), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia.
Saoussen Chouchène
Human genome and multifactorial diseases research laboratory (LR12ES07), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia.
Maha Mastouri
Microbiology Laboratory, Fattouma Bourguiba University Hospital Centre, Monastir. Transmissible Diseases and Biologically Active Substances Research Laboratory (LR99ES27), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia.
Hamouda Babba
Parasitology - Medical and Molecular Mycology Research Laboratory (LR12ES08), Faculty of Pharmacy of Monastir, University of Monastir, Tunisia

Abstract

Introduction: According to the World Health Organization, Microscopy is the gold standard for diagnosing malaria. However, the performance of this examination depends on the experience of the microscopist and the level of parasitemia. Thus, molecular biology detection of malaria could be an alternative technique.


Aim: evaluate the contribution of molecular biology in detecting imported malaria.


Methods: This was a descriptive, prospective study, including all students, from the Monastir region, and foreigners, from countries endemic to malaria. The study period was from September 2020 to April 2021. Each subject was screened for malaria by three methods: direct microscopic detection of Plasmodium, detection of plasmodial antigens, and detection of plasmodial DNA by nested PCR.


Results: Among the 127 subjects screened, only one had a positive microscopic examination for Plasmodium falciparum. Among the 126 subjects with a negative microscopic examination, twelve students had a positive nested PCR result, i.e. 9.5%. Molecular sequencing allowed the identification of ten isolates of Plasmodium falciparum, one Plasmodium malariae and one Plasmodium ovale. Our study showed that the results of nested PCR agreed with those of microscopy in 90.6% of cases.


Conclusion: Nested PCR seems more sensitive for the detection of low parasitemias. Hence the importance of including molecular biology as a malaria screening tool to ensure better detection of imported cases.

Keywords:

Plasmodium, Diagnostic Screening Programs, Molecular Biology, Microscopy, Tunisia

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