Browsing by Subject "PCR"

Background: Recent epidemiological studies demonstrate that the prevalence of the fifth major human malaria parasite, Plasmodium knowlesi (monkey malaria), is often underestimated and misdiagnosed with standard microscopy blood film. We sought to adapt and compare a new simple molecular diagnostic method for P. knowlesi with the gold standard nested molecular assay and microscopy blood film in P. knowlesi hotspot areas in Sarawak, Malaysia. In addition, we analyzed the statistical association between P. knowlesi positive test results and demographic and behavioral/occupational risk factors.

Methods: The study was conducted at Sibu, Kapit and Sarikei Hospitals in Sarawak, Malaysia. 115 blood samples were collected from malaria suspected patients seeking treatment at these hospitals. Samples were analyzed by microscopy, Nested polymerase chain reaction (PCR) and single-step PCR. Sensitivity, specificity, and practical value of the new single-step PCR assay was calculated. Bivariate and multivariate regression was conducted to test the possible risk factors for the detection of P. knowlesi.

Results: Single-step PCR showed low sensitivity (51.92%, 95%CI 37.63 - 65.99%) compared to nested PCR and 46.03% (95%CI 33.39 - 59.06%) compared to microscopy. When compared to nested PCR, microscopy had a false positive rate of 20.6%. However, it only missed 2 cases of P. knowlesi. The mean age in the study population was 40.35. Patients enrolled at Kapit hospital had higher odds ratio for positive P. knowlesi PCR results (adjusted OR = 4.46, 95%CI 1.16 – 11.51). Age above 21 years (adjusted OR = 6.28, 95%CI 1.53 – 25.64), male gender (adjusted OR = 2.46, 95%CI 0.91 – 6.65) and living near a vegetation (Plantation, forest, fruit trees or wet rice paddy) (adjusted OR = 5.96, 95%CI 1.11 – 31.83) were associated with increased risk for P. knowlesi infection.

Conclusions: Data from this study showed that single-step PCR has a low sensitivity and thus, it is not a suitable alternative for accurate detection of P. knowlesi. Further studies are required for assessment and development of other diagnostic assays or new primer sets. Multivariate analysis revealed that adult men over the age of 21 who live near agricultural areas have the highest risk for P. knowlesi malaria infection. Large- scale descriptive studies of both non-human hosts and vectors would greatly influence prevention and control strategies of this zoonotic disease.

The adenoviruses are nonenveloped double stranded DNA viruses, which cause enteric dysentary and respiratory infection. Adenovirus has become a focus of the water treatment community because of its apparent resistance to ultraviolet disinfection; it is the basis for stringent new EPA regulations regarding all viruses in both surface and ground waters. Most of the work done so far, however, has involved the use of monochromatic (254 nm) low pressure (LP) UV sources and subsequent assay of viral infectivity in cell culture models. LP UV lamps primarily damage DNA, while polychromatic UV sources may damage other parts of the virus as well. Recent research has shown that these newer, polychromatic UV sources--such as medium pressure (MP) UV--are more effective than monochromatic LP UV for disinfection of adenovirus. The objectives of this work were to study adenoviral response to UV using both LP and MP UV as well as using both standard cell culture infectivity assays and more direct methods of assessment based on molecular biology. These include quantitative long PCR for assessment of DNA damage and SDS-PAGE for assessment of protein damage; transmission electron microscopy was used to examine the structure of UV treated viral particles. This work was only the second significant study to show the response of adenoviruses to medium pressure UV and the first to thoroughly examine the response of adenoviruses to both LP and MP UV using cell culture-independent methods. Results confirm that adenovirus is sensitive to MP UV when assayed in cell culture; they show that LP and MP UV are equally effective at inducing damage to the adenoviral genome and that MP UV is more effective than LP UV at damaging the viral proteins. This work helps deepen our understanding of UV disinfection of adenovirus.