Usefulness of Polymerase Chain Reaction to Supplement Field Microscopy in a Pre-Selected Population with a High Probability of Malaria Infections

W. M. Kumudunayana T. de A. W. Gunasekera National Anti-Malaria Campaign Headquarters, 555/5 Elvitigala Mawatha, Colombo, Sri Lanka; Department of Zoology, Faculty of Science, University of Colombo, Sri Lanka; Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka

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Rabindra R. Abeyasinghe National Anti-Malaria Campaign Headquarters, 555/5 Elvitigala Mawatha, Colombo, Sri Lanka; Department of Zoology, Faculty of Science, University of Colombo, Sri Lanka; Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka

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Sunil Premawansa National Anti-Malaria Campaign Headquarters, 555/5 Elvitigala Mawatha, Colombo, Sri Lanka; Department of Zoology, Faculty of Science, University of Colombo, Sri Lanka; Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka

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S. Deepika Fernando National Anti-Malaria Campaign Headquarters, 555/5 Elvitigala Mawatha, Colombo, Sri Lanka; Department of Zoology, Faculty of Science, University of Colombo, Sri Lanka; Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka

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This study determines the use of nested PCR as a diagnostic tool to supplement field microscopy in symptomatic individuals suspected of being positive for malaria, and it explores its role in active case detection to identify asymptomatic parasite carriers. In symptomatic individuals, compared with PCR, microscopy had a sensitivity of 86.6% (95% confidence interval [CI] = 77.8–92.4) and specificity of 100% (95% CI = 96.9–100). During active case detection, two asymptomatic persons were diagnosed as having vivax malaria by polymerase chain reaction (PCR) but not microscopy. Currently, PCR is being carried out in Sri Lanka only for population surveys to estimate the hidden reservoir of malaria. Based on the results of this study and because of cost considerations, pooled PCR will be used in the future to screen samples from clinically suspected foci to increase the proportion of malaria cases detected. This strategy will assist the success of the malaria elimination program in Sri Lanka.

Author Notes

*Address correspondence to S. Deepika Fernando, Department of Parasitology, Faculty of Medicine, University of Colombo, Kynsey Rd., PO Box 271, Colombo 8, Sri Lanka. E-mail: deepfern@slt.lk

Financial support: This study was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) under Grant SRL-102-G02-M-00.

Authors' addresses: W. M. Kumudunayana T. de A. W. Gunasekera and Rabindra R. Abeyasinghe, National Anti-Malaria Campaign, Colombo, Sri Lanka, E-mails: kumudunayana@yahoo.com and rabindraabeyasinghe@gmail.com. Sunil Premawansa, Department of Zoology, Faculty of Science, University of Colombo, Sri Lanka, E-mail: supre@zoology.cmb.ac.lk. S. Deepika Fernando, Department of Parasitology, Faculty of Medicine, University of Colombo, Sri Lanka, E-mail: deepfern@slt.lk.

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