Efficacy of Histochemical Staining Techniques in the Detection of Plasmodium falciparum Histidine-Rich Proteins in Blood of Children with Malaria

Authors : Mfoniso UDONKANG, Mokutima ELUWA, Paul INYANGETOH, İmeobong INYANG, Amabe AKPANTAH, Theresa EKANEM

Pages : 55-60

Doi:10.5799/jmid.434593

View : 11 | Download : 6

Publication Date : 2018-06-20

Article Type : Research Paper

Abstract :Objective: Falciparum malaria predominates in sub-Saharan Africa and children below five years are the most vulnerable. Giemsa-stained microscopy is the gold standard in malaria diagnosis. Diagnosis with rapid diagnostic test insert ignore into journalissuearticles values(RDT); kit is also common and over 80% of available malaria RDT kits is Plasmodium falciparum histidine-rich protein 2-based insert ignore into journalissuearticles values(Pfhrp2);. However, these histidine-rich protein 2-based kits have been observed to give false positive and negative results due to persistent antigenemia and low parasitaemia respectively. Thus, the methods of Pauly, Perls, and Means & Feeney were adopted to explore the advantage of using microscopy for specific detection of these histidine-rich proteins and their usefulness in detecting low parasitemia in children. Methods: Children aged 0-5 years insert ignore into journalissuearticles values(n=200); visiting three hospitals and private laboratories in Calabar were recruited. Whole blood samples were tested with CareStart Malaria HRP2-based kit, and blood films were made and stained with Giemsa, Pauly, Perls and Means & Feeney for microscopy. Results: The sensitivity and specificity were Giemsa insert ignore into journalissuearticles values(56.4%, 79.8%);, Means & Feeney insert ignore into journalissuearticles values(52.5%, 77.8%);, Perls insert ignore into journalissuearticles values(47.5%, 85.9);, Pauly insert ignore into journalissuearticles values(45.5%, 86.9%);, and RDT insert ignore into journalissuearticles values(23.8%, 96%);. Pauly method had the highest area under the curve of 0.830 while RDT method had the lowest of 0.661. Among the positive cases low parasitemia detected by the histochemical methods was Perls 36 insert ignore into journalissuearticles values(75%);, Pauly 32 insert ignore into journalissuearticles values(69.6%);, and Means & Feeney 34 insert ignore into journalissuearticles values(64.2%);, and for Giemsa method 40 insert ignore into journalissuearticles values(70.2%);. Conclusion: Pauly method was the most accurate. All three methods were sensitive in detecting low parasitemia. These diagnostic methods are useful in malaria diagnosis in this endemic population. J Microbiol Infect Dis 2018; 8insert ignore into journalissuearticles values(2);:55-60
Keywords : Histochemical stains, Histidine rich proteins, Malaria, Plasmodium falciparum, Efficacy