Malaria is a major cause of morbidity and mortality. Treatment of malaria in a timely manner could avert deaths. Treatment ultimately relies on the rapid and accurate diagnosis. Fluorescence in situ hybridization (FISH), a cytogenetic technique based on detection of specific nucleic acid, has the potential to address the limitations of the current diagnostic approaches. This study investigates further the performance of FISH for the diagnosis of malaria in a rural setting in Western Kenya.
Blood samples from 302 patients presenting with fever (temperature ≥ 37.5 °C) were examined for malaria using the Giemsa microscopy (GM), rapid diagnostic test (RDT), polymerase chain reaction (PCR) and FISH.
The sensitivity and specificity of FISH was 85.6% and 96.2% respectively, while the corresponding values for GM were 82.2% and 100% respectively. RDT and PCR had sensitivities of 91.1% and 98.9%, respectively with their specificities being 89.6 and 100%, respectively. The positive predictive values for RDT, GM, FISH and PCR were 78.8%, 100%, 90.6% and 100%, respectively. The negative predictive values for RDT, GM, FISH and PCR were 96.0%, 93.0%, 94.0% and 99.5%, respectively. Their respective diagnostic accuracies were 90.1%, 94.7% 93.0% and 99.7%.
The present study demonstrates that the specificity and reproducibility of FISH assays are high, thus adding to the growing evidence on the potential of the technique as an effective tool for the detection of malaria parasites in remote settings.
World Health Organization (WHO): World Malaria Report 2012. http://www.who.int/malaria/publications/world_malaria_report_2012/en (2012). Accessed Feb 2015.
WHO: World Malaria Report. http://www.who.int/malaria/publications/world_malaria_report_2014/en (2014). Accessed April 2015.
United Nations Children Fund (Unicef): The reality of malaria. The largest killer of children. https://www.unicef.org/health/files/health_africamalaria.pdf (2016). Accessed Feb 2015.
WHO: Fact Sheet: World Malaria Report 2015. WHO. Geneva. http://www.who.int/malaria/publications/world-malaria-report-2016/report/en (2015). Accessed Dec 2016.
Amexo M, Tolhurst R, Barnish G, Bates I. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet. 2004;364(9448):186–9. CrossRef
Government of Kenya (GOK), Ministry of Public Health and Sanitation (MOPHS). National Malaria Strategy 2009-2017. Nairobi: MOPHS; 2009.
GOK, Ministry of Health. Kenya-Malaria- Operational-Plan. Nairobi: Government Press; 2015.
WHO. In Kenya, the path to elimination of malaria is lined with good preventions. http://www.who.int/features/2017/vector-control-kenya/en/(2017). Accessed Sept 2017.
WHO: World Malaria Report 2011. http://www.who.int/malaria/world_malaria_report_2011/en (2012). Accessed Jan 2016.
Boyce MR, O’Meara WP. Use of malaria RDTs in various health contexts across sub-Saharan Africa: a systematic review. BMC public health. 2017: 18;17(1):470.
Maltha J, Gillet P, Jacobs J. Malaria rapid diagnostic tests in endemic settings. Clin Microbiol & Infection. 2013;19:399–407. CrossRef
Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg. 2007;77(6):119–27. PubMed
Mahende C, Ngasala B, Lusingu J, Yong TS, Lushino P, Lemnge M, Mmbando B, Premji Z. Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe District, Tanzania. Malar J. 2016 26; 15(1):391.
Kenya National Bureau of Statistics and ORC Macro. Kenya demographic and health survey 2008–09. Nairobi, Kenya and Calverton, Maryland, USA: KNBS and ORC Macro; 2010.
Shah J, Mark O, Weltman H, Barcelo N, Lo W, Wronska D, Kakkilaya S, Rao A, Bhat ST, Sinha R, Omar S, O’bare P, Moro M, Gilman RH, Harris N. Fluorescence in situ hybridization (FISH) assays for diagnosing malaria in endemic areas. PLoS One. 2015;10:e0136726. https://doi.org/10.1371/journal.pone.0136726. CrossRefPubMedPubMedCentral
Shah J, Weltman H, Narciso P, Murphy C, Poruri A, Baliga S, Sharon L, York M, Cunningham G, Miller S, Caviedes L. Dual color fluorescence in situhybridization (FISH) assays for detecting Mycobacterium tuberculosis and Mycobacterium avium complexes and related pathogens in cultures. PLoS One. 2017;12(4):e0174989. https://doi.org/10.1371/journal.pone.0174989. CrossRefPubMedPubMedCentral
Osoga J, Waitumbi J, Guyah B, Sande J, Arima C, Ayaya M, Moseti C, Morang’a C, Wahome M, Achilla R, Awinda G. Comparative evaluation of fluorescent in situ hybridization and Giemsa microscopy with quantitative real-time PCR technique in detecting malaria parasites in a holoendemic region of Kenya. Malar J . 2017: 24; 16(1):297. https://doi.org/10.1186/s12936-017-1943-4.
Lwanga SK, Lemeshow S. Determining sample size health studies: a practical manual. Geneva: WHO; 1991.
National Malaria Control Programme (NMCP), Kenya National Bureau of Statistics (KNBS), and ICF International. Kenya Malaria Indicator Survey 2015. Nairobi, Kenya, and Rockville, Maryland, USA: NMCP, KNBS, and ICF International; 2016.
WHO. Severe malaria. Trop Med Int Health. 2014. 19 (Suppl 1): 7–131. http://www.who.int/malaria/publications/atoz/who-severe-malaria-tmih-supplement-2014.pdf. Accessed Sept 2017. https://doi.org/10.1111/tmi.12313
WHO: Basic Malaria Microscopy. Geneva: WHO; 1991.
WHO: Basic Malaria Microscopy.2010. http://whqlibdoc.who.int/publications/2010/9789241547826 eng.pdf. Accessed Mar 2015.
Stender H, Mollerup TA, Lund K, Peterson KH, Hongmanee P, Godtfredsen SE. Direct detection hybridization (FISH) using peptide nucleic acid (PNA) probes. Int J Tuberc Lung Dis. 1999;3(9):830–7. PubMed
Shah JS, Harris NS. In situ-hybridization for detecting target nucleic acid. US Patent No. 2000;6:165,723.
DeLong EF, Shah J. Fluorescent, ribosomal RNA probes for clinical application: a research review. Diagn Clin Testing. 1990;28:41–4.
Graczyk TK, Grimes BH, Knight R, da Silva AJ, Pieniazek NJ, Veal DA. Detection of Cryptosporidium Parvum and Giardia Lamblia carried by synanthropic flies by combined fluorescent in situ hybridization and a monoclonal antibody. Am J Trop Med Hyg. 2003;68(2):228–32. PubMed
Shah JS, Harris NS. Detection of Babesia microti by Fluorescent In Situ-Hybridization. 39th international conference on. Antimicrob Agents Chemother. 1999:127–9.
Sharon L, Baliga S, Shah J, Murphy C, Weltman H. Fluorescent In Situ Hybridization (FISH) for the detection and differentiation of mycobacterium tuberculosis and NTM in sputum and culture. International Journal of Infectious Diseases. 2016;45(Suppl 1–7)
- Evaluation of fluorescent in-situ hybridization technique for diagnosis of malaria in Ahero Sub-County hospital, Kenya
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