Malaria Prevalence in a Low Transmission Area, Jazan District of Southwestern Saudi Arabia
10.3347/kjp.2019.57.3.233
- Author:
Yousry HAWASH
1
;
Khadiga ISMAIL
;
Khalaf ALSHARIF
;
Walaa ALSANIE
Author Information
1. Clinical Laboratories Sciences Department, College of Applied Medical Science, Taif University, Taif, Saudi Arabia. yousryhawash@gmail.com
- Publication Type:Original Article
- Keywords:
Malaria diagnosis;
nested PCR;
Paramax-3™;
sub-microscopic/asymptomatic infections;
Saudi Arabia
- MeSH:
Adult;
Coinfection;
Diagnosis;
Female;
Fever;
Humans;
Malaria;
Male;
Microscopy;
Plasmodium falciparum;
Polymerase Chain Reaction;
Prevalence;
Saudi Arabia;
Sensitivity and Specificity;
Tertiary Healthcare
- From:The Korean Journal of Parasitology
2019;57(3):233-242
- CountryRepublic of Korea
- Language:English
-
Abstract:
Detailed description of malaria in low transmission areas is crucial for elimination. The current study aimed to provide a comprehensive description for malaria transmission in Jazan, a low transmission district, southwestern Saudi Arabia. Patients at a tertiary care hospital were recruited in our study between August 2016 and September 2018. Malaria diagnosis was performed through a species-specific nested polymerase chain reaction (nested PCR), microscopy and Paramax-3™ rapid detection test (RDT). Malaria was detected in 30 patients by the PCR, with point prevalence of 10.9%. Of these malaria infections, 80% was imported, 26.6% was asymptomatic and 23.3% was sub-microscopic. Malaria was reported throughout the year, with February/March and September/October peaks. Infection was significantly more in males than in females (P=0.01). Likewise, infections were detected more in febrile than in non-febrile patients (P=0.01). Adult aged 15–24 years, fever and travel were identified as high-risk factors. Malaria was primarily attributed to Plasmodium falciparum mono-infections, followed by P. vivax mono-infections and lastly to falciparum/vivax mixed infections accounting 76.6%, 16.6%, and 6.6% of PCR-confirmed malaria cases, respectively. The nested PCR was superior to the smear microscopy (sensitivity 76.6%; specificity 100%) and the RDT (sensitivity 83.3%, specificity 94.2%). The overall percent agreement between microscopy and the RDT was 92.7% (kappa=0.63). High proportion of imported malaria including sub-microscopic and sub-patent cases were described. We suggest that incorporation of molecular tool into the conventional malaria diagnosis is beneficial in Jazan district.
