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Symptomatic Plasmodium vivax Infection in Rwanda
Jessica N McCaffery1,2, Tharcisse Munyaneza3, Aline Uwimana4
1Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Open Forum Infectious Diseases
|February 21, 2022
Summary
A Rwandan child was misdiagnosed with Plasmodium falciparum malaria. Diagnostic tests confirmed the infection was actually Plasmodium vivax, highlighting potential diagnostic challenges in malaria detection.
Area of Science:
- Tropical medicine
- Infectious diseases
- Molecular diagnostics
Background:
- Plasmodium falciparum and Plasmodium vivax are the most common malaria parasites.
- Accurate species identification is crucial for effective treatment and disease control.
- Diagnostic errors can lead to inappropriate treatment and prolonged illness.
Purpose of the Study:
- To report a case of Plasmodium vivax malaria misdiagnosed as Plasmodium falciparum in a child.
- To highlight the importance of accurate malaria parasite species identification.
- To evaluate diagnostic methods for differentiating Plasmodium species.
Main Methods:
- Antigen detection tests for Plasmodium falciparum histidine-rich protein 2 (HRP2) and Plasmodium vivax lactate dehydrogenase.
- Nested and real-time polymerase chain reaction (PCR) for Plasmodium DNA detection and species confirmation.
Main Results:
- Antigen detection was negative for P. falciparum HRP2 and positive for P. vivax lactate dehydrogenase.
- Nested and real-time PCR confirmed the presence of P. vivax DNA exclusively.
- The child received artemether-lumefantrine for presumed P. falciparum infection.
Conclusions:
- Misdiagnosis of malaria species can occur, impacting patient management.
- Antigen detection and molecular methods are valuable tools for accurate Plasmodium species identification.
- Prompt and correct diagnosis is essential for effective malaria treatment, especially in endemic regions.
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