Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagno
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Malaria Journal Open Access
RESEARCH
Molecular epidemiological surveillance of Africa and Asia imported malaria in Wuhan, Central China: comparison of diagnostic tools during 2011–2018 Yiting Xie1,2†, Kai Wu3†, Weijia Cheng1,2, Tingting Jiang1,2, Yi Yao1,2, Mingxing Xu3, Yan Yang3, Huabing Tan1,2 and Jian Li1,2*
Abstract Background: 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. 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. Methods: Blood 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. Results: A 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. Conclusions: These 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. Keywords: Imported malaria, Microscopic examination, Molecular diagnosis, Rapid diagnosis test, Nested PCR, Realtime PCR
*Correspondence: [email protected] † Yiting Xie and Kai Wu contributed equally 1 Department of Human Parasitology, School of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, People’s Republic of China Full list of author information is available at the end of the article
Background Malaria remains a serious threat to public health around the world, with an estimated 228 million cases and 405,000 deaths in 2018 worldwide [1]. The main epidemic areas of malaria are distributed in Africa (93%), followed by Southeast Asia (SE Asia) (3.4%) and the
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provi
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