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- W4236037838 abstract "Abstract Background: The use of molecular diagnostics has revealed an unexpectedly large number of asymptomatic low-density malaria infections in many malaria endemic areas. This study compared the gains in parasite prevalence obtained by the use of ultra-sensitive (us)-qPCR as compared to standard qPCR in cross sectional surveys conducted in Thailand, Brazil and Papua New Guinea (PNG). The compared assays differed in the copy number of qPCR targets in the parasite genome. Methods: Plasmodium falciparum ( Pf ) and P. vivax ( Pv ) parasites were quantified by qPCR amplifying the low-copy Pf_ and Pv _18S rRNA genes or the multi-copy targets Pf _varATS and Pv _mtCOX1. Cross sectional surveys at the three study sites included 2252 participants of all ages and represented different transmission intensities. Results: In the two low-transmission areas, Pf positivity was 1.3% (10/773) (Thailand) and 0.8% (5/651) (Brazil) using standard Pf _18S rRNA qPCR. In these two countries, Pf positivity by Pf_ varATS us-qPCR increased to 1.9% (15/773) and 1.7% (11/651). In PNG, an area with moderate transmission intensity, Pf positivity significantly increased from 8.6% (71/828) by standard qPCR to 12.2% (101/828) by us-qPCR. The proportions of Pf infections not detected by standard qPCR were 33%, 55% and 30% in Thailand, Brazil and PNG. Pv was the predominating species in Thailand and Brazil, with 3.9% (30/773) and 4.9% (32/651) positivity by Pv _18S rRNA qPCR. In PNG, Pv positivity was similar to Pf , at 8.0% (66/828). Use of Pv _mtCOX1 us-qPCR led to a significant increase in positivity to 5.1% (39/773), 6.4% (42/651) and 11.5% (95/828) in Thailand, Brazil, and PNG. The proportions of Pv infections missed by standard qPCR were similar at all three sites, with 23%, 24% and 31% in Thailand, Brazil and PNG. Conclusion: The proportional gains in the detection of Pf and Pv infections by ultra-sensitive diagnostic assays were substantial at all three study sites. Thus, us-qPCR yields more precise prevalence estimates for both Pf and Pv at all studied levels of endemicity and represents a significant diagnostic improvement. Improving sensitivity in Pv surveillance by us-qPCR is of particular benefit, because the additionally detected Pv infections signal the potential presence of hypnozoites and subsequent risk of relapse and further transmission." @default.
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- W4236037838 date "2020-07-29" @default.
- W4236037838 modified "2023-10-06" @default.
- W4236037838 title "Utility of ultra-sensitive qPCR to detect Plasmodium falciparum and P. vivax infections under different transmission intensities" @default.
- W4236037838 doi "https://doi.org/10.21203/rs.3.rs-25965/v2" @default.
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