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

Year 2018, Volume: 08 Issue: 02, 55 - 60, 20.06.2018

Mfoniso Udonkang Mokutima Eluwa Paul Inyang-etoh İmeobong Inyang Amabe Akpantah Theresa Ekanem

https://doi.org/10.5799/jmid.434593

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 (RDT) kit
is also common and over 80% of available malaria RDT kits is Plasmodium falciparum histidine-rich
protein 2-based (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 (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 (56.4%, 79.8%), Means & Feeney
(52.5%, 77.8%), Perls (47.5%, 85.9), Pauly (45.5%, 86.9%), and RDT (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 (75%), Pauly 32 (69.6%), and Means &
Feeney 34 (64.2%), and for Giemsa method 40 (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; 8(2):55-60

Keywords

Histochemical stains, Histidine-rich proteins, Malaria, Plasmodium falciparum, Efficacy

References

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