The comparison of the immünochromatographic method with thick blood examination for diagnosis of plasmodium vivax malaria

ABSTRACTTHE COMPARISON OF THE IMMUNOCHROMATOGRAPHIC METHODWITH THICK BLOOD EXAMINATION FOR DIAGNOSIS OF PLASMODIUMVIVAX MALARIAMore than 3 billion people live in malarious regions at the worldwide. Everyyear 300 million people suffering from malarial infection and 2.5 million people diefrom the malaria. There are four species causing human malaria. Ninety five percent ofall human malaria is caused by Plasmodium vivax. The bite of female Anophelesmosquito transmits the malaria parasite to humans and develop malaria epidemics.These epidemics have strong effects on the health infrastructure and local economics indeveloping countries. The classical gold standart method for detection of the malariaparasite is the examination of thick blood films. However, rapid malaria tests have beenintroduced as an alternative conventional microscopic methods for the diagnosis ofmalaria.The OptiMAL test is an immunochromatographic rapid malaria test based on thedipstick principle which was designed to provide colorimetric determination bydeveloping antibody to the lactate dehydrogenase enzyme of the parasite. It detects ofPlasmodium vivax and Plasmodium falciparum malaria in whole blood.Our study was conducted in Diyarbakır province including Diyarbakır centrum,Silvan and Bismil district during the period of May 2004-October 2005. A total of 109whole blood samples were obtained from patient with malaria-like symptoms from therural and urban areas for thick blood films and OptiMAL test. In addition, parasitedensity was calculated for each positive thick film. As a result of our study the eightythree patients were diagnosed having Plasmodium vivax malaria using examinationthick films and eighty four patients were positive according to the OptiMAL test.A patient having Plasmodium vivax malaria on the basis of thick film, the OptiMALtest is negative. Two patients is positive according to the OptiMAL test, while theirthick films result is negative.viiWhen the thick blood film is accepted of the gold standard method, we foundthat the OptiMAL test have a sensitivity 98,8 %; a specificity 92,3 %; a positivepredictive value 97,6 % and a negative predictive value 96 % in our study.As a result, the rapid malarial diagnosis test, OptiMAL is simple, specific, andefficient and it can be used in the diagnosis of Plasmodium vivax malaria in fieldstudies.Keywords: Plasmodium vivax, Diagnosis, OptiMAL test, Thick blood film.viii