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. 2013 May 24;12:169.
doi: 10.1186/1475-2875-12-169.

Epidemiology of Plasmodium Infections in Flores Island, Indonesia Using Real-Time PCR

Free PMC article

Epidemiology of Plasmodium Infections in Flores Island, Indonesia Using Real-Time PCR

Maria M M Kaisar et al. Malar J. .
Free PMC article


Background: DNA-based diagnostic methods have been shown to be highly sensitive and specific for the detection of malaria. An 18S-rRNA-based, real-time polymerase chain reaction (PCR) was used to determine the prevalence and intensity of Plasmodium infections on Flores Island, Indonesia.

Methods: Microscopy and real-time multiplex PCR for the detection of Plasmodium species was performed on blood samples collected in a population-based study in Nangapanda Flores Island, Indonesia.

Results: A total 1,509 blood samples were analysed. Real-time PCR revealed prevalence for Plasmodium falciparum, Plasmodium vivax, and Plasmodium malariae to be 14.5%, 13.2%, and 1.9% respectively. Sub-microscopic parasitaemia were found in more than 80% of all positive cases. The prevalence of P. falciparum and P. vivax was significantly higher in subjects younger than 20 years (p ≤ 0.01). In the present study, among non-symptomatic healthy individuals, anaemia was strongly correlated with the prevalence and load of P. falciparum infections (p ≤ 0.01; p = 0.02) and with the load of P. vivax infections (p = 0.01) as detected with real-time PCR. Subjects with AB blood group tend to have a higher risk of being infected with P. falciparum and P. vivax when compared to other blood groups.

Conclusion: The present study has shown that real-time PCR provides more insight in the epidemiology of Plasmodium infections and can be used as a monitoring tool in the battle against malaria. The unsurpassed sensitivity of real-time PCR reveals that sub microscopic infections are common in this area, which are likely to play an important role in transmission and control.

Trial registration: Trials number ISRCTN83830814.


Figure 1
Figure 1
Location of three sub villages enrolled in the study where each black dot represents the house hold.
Figure 2
Figure 2
Flow chart: Cases available for describing the epidemiology of Plasmodium infections in Flores Island, Indonesia using real-time PCR.
Figure 3
Figure 3
Age distribution detected with real-time PCR divided in to cases with a high, moderate, and low DNA load of: A. P. falciparum infections; B. P. vivax infections.

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