Evaluation of Multiplex/Nested Polymerase Chain Reaction and Loop-Mediated Isothermal Amplification for Malaria Diagnosis in Southeastern Iran

Hadi Mirahmadi Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;
Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Azam Shahrakipour Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;
Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Ahmad Mehravaran Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;
Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Mansour Rahmati-Balaghaleh Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;
Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Mehdi Zarean Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;
Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;

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Soodabeh Etemadi Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran;
Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Mehdi Shahraki Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran;

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Rahmat Solgi Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran;
Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran

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ABSTRACT.

Malaria is one of the most serious health problems in many countries, including Iran. Accurate diagnosis is important regardless of the elimination status of a country. A cross-sectional study was performed on 105 people who were suspected to be positive for malaria infection in Sistan and Baluchistan, Iran. Blood smears (thin and thick films) were stained with 10% Giemsa. DNA was extracted from the prepared thin and thick films for molecular methods. Multiplex/nested polymerase chain reaction (mn-PCR), loop-mediated isothermal amplification (LAMP), and light microscopy (LM) were compared with nested PCR (nPCR) as a gold standard. Of 105 subjects, 52 (49.5%), 58 (55.2%), 58 (55.2%), and 63 (60%) were positive for malaria by LM, nPCR, mn-PCR, and LAMP, respectively. The sensitivity, specificity, and kappa were 92.1%, 100%, and 0.9 for LAMP and 100%, 100%, and 1 for mn-PCR, respectively. Eight cases of coinfection (Plasmodium vivax and Plasmodium falciparum) that were not detected by LM method were diagnosed by mn-PCR and LAMP. In the present study, the high sensitivity and specificity of LAMP and mn-PCR indicate that these two tests are good alternatives to nPCR for malaria diagnosis

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Author Notes

Address correspondence to Rahmat Solgi, Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran, E-mail: rahmatsolgi@yahoo.com or Mehdi Zarean, Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, E-mail: zareanm@mums.ac.ir.

Financial support: This study supported by the grant no. 7700, provided from Zahedan University of Medical Sciences, Zahedan, Iran.

Disclosure: All procedures in this investigation were reviewed and approved by the Ethics Committee of Zahedan University of Medical Sciences (IR.Zaums.fm.REC.1395.17). Oral consent was obtained from the participants before sampling.

Authors’ addresses: Hadi Mirahmadi, Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Sistan and Baluchestan, Iran, E-mail: trajaiii81@yahoo.com. Azam Shahrakipour, Ahmad Mehravaran, Mansour Rahmati-Balaghaleh, Soodabeh Etemadi, and Mehdi Shahraki, Department of Parasitology and Mycology, Zahedan University of Medical Sciences, Zahedan, Sistan and Baluchestan, Iran, E-mails: namamianfarshid@yahoo.com, s.jstbiology@yahoo.com, rahnamamahsa783@yahoo.com, sshafaii@yahoo.com, asgariq@yahoo.com. Mehdi Zarean, Mashhad University of Medical Sciences, Parasitology and mycology, Mashhad, Iran, E-mail: mo.di75@yahoo.com. Rahmat Solgi, Birjand University of Medical Sciences, Medical Microbiology, Birjand, Iran, E-mail: rahmatsolgi@yahoo.com.

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