Diagnosis and treatment based on quantitative PCR after controlled human malaria infection
Abstract Background Controlled human malaria infection (CHMI) has become well-established in the evaluation of drugs and vaccines. Anti-malarial treatment is usually initiated when thick blood smears are positive by microscopy. This study explores the effects of using the more sensitive qPCR as the...
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ftdoajarticles:oai:doaj.org/article:2d22cdb3f16e44c5a0b6794fd861c5a4 2023-05-15T15:09:50+02:00 Diagnosis and treatment based on quantitative PCR after controlled human malaria infection Jona Walk Remko Schats Marijke C. C. Langenberg Isaie J. Reuling Karina Teelen Meta Roestenberg Cornelus C. Hermsen Leo G. Visser Robert W. Sauerwein 2016-08-01T00:00:00Z https://doi.org/10.1186/s12936-016-1434-z https://doaj.org/article/2d22cdb3f16e44c5a0b6794fd861c5a4 EN eng BMC http://link.springer.com/article/10.1186/s12936-016-1434-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-016-1434-z 1475-2875 https://doaj.org/article/2d22cdb3f16e44c5a0b6794fd861c5a4 Malaria Journal, Vol 15, Iss 1, Pp 1-7 (2016) Malaria Plasmodium falciparum Controlled human malaria infection (CHMI) quantitative PCR (qPCR) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2016 ftdoajarticles https://doi.org/10.1186/s12936-016-1434-z 2022-12-30T22:50:04Z Abstract Background Controlled human malaria infection (CHMI) has become well-established in the evaluation of drugs and vaccines. Anti-malarial treatment is usually initiated when thick blood smears are positive by microscopy. This study explores the effects of using the more sensitive qPCR as the primary diagnostic test. Methods 1691 diagnostic blood samples were analysed by microscopy and qPCR from 115 volunteers (55 malaria naïve and 60 having received chemoprophylaxis and sporozoite immunization) who were challenged by five mosquitoes infected with Plasmodium falciparum sporozoites of the NF54 strain. Results Retrospective analysis of different qPCR criteria for diagnosis and treatment, showed that once daily qPCR (threshold 100 parasites/ml) had 99 % sensitivity and 100 % specificity, and shortened the median prepatent period from 10.5 to 7.0 days after CHMI when compared to twice daily measurement of thick blood smears (threshold 4000 parasites/ml). This is expected to result in a 78 % decrease of adverse events before initiation of treatment in future studies. Trial outcome related to infection and protective efficacy remained unchanged. Conclusion The use of qPCR as the primary diagnostic test in CHMI decreases symptoms as well as parasitaemia while obviating the need for twice daily follow-up. The implementation improves safety while reducing the clinical burden and costs without compromising the evaluation of protective efficacy. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 15 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Malaria Plasmodium falciparum Controlled human malaria infection (CHMI) quantitative PCR (qPCR) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria Plasmodium falciparum Controlled human malaria infection (CHMI) quantitative PCR (qPCR) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Jona Walk Remko Schats Marijke C. C. Langenberg Isaie J. Reuling Karina Teelen Meta Roestenberg Cornelus C. Hermsen Leo G. Visser Robert W. Sauerwein Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
topic_facet |
Malaria Plasmodium falciparum Controlled human malaria infection (CHMI) quantitative PCR (qPCR) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Controlled human malaria infection (CHMI) has become well-established in the evaluation of drugs and vaccines. Anti-malarial treatment is usually initiated when thick blood smears are positive by microscopy. This study explores the effects of using the more sensitive qPCR as the primary diagnostic test. Methods 1691 diagnostic blood samples were analysed by microscopy and qPCR from 115 volunteers (55 malaria naïve and 60 having received chemoprophylaxis and sporozoite immunization) who were challenged by five mosquitoes infected with Plasmodium falciparum sporozoites of the NF54 strain. Results Retrospective analysis of different qPCR criteria for diagnosis and treatment, showed that once daily qPCR (threshold 100 parasites/ml) had 99 % sensitivity and 100 % specificity, and shortened the median prepatent period from 10.5 to 7.0 days after CHMI when compared to twice daily measurement of thick blood smears (threshold 4000 parasites/ml). This is expected to result in a 78 % decrease of adverse events before initiation of treatment in future studies. Trial outcome related to infection and protective efficacy remained unchanged. Conclusion The use of qPCR as the primary diagnostic test in CHMI decreases symptoms as well as parasitaemia while obviating the need for twice daily follow-up. The implementation improves safety while reducing the clinical burden and costs without compromising the evaluation of protective efficacy. |
format |
Article in Journal/Newspaper |
author |
Jona Walk Remko Schats Marijke C. C. Langenberg Isaie J. Reuling Karina Teelen Meta Roestenberg Cornelus C. Hermsen Leo G. Visser Robert W. Sauerwein |
author_facet |
Jona Walk Remko Schats Marijke C. C. Langenberg Isaie J. Reuling Karina Teelen Meta Roestenberg Cornelus C. Hermsen Leo G. Visser Robert W. Sauerwein |
author_sort |
Jona Walk |
title |
Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
title_short |
Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
title_full |
Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
title_fullStr |
Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
title_full_unstemmed |
Diagnosis and treatment based on quantitative PCR after controlled human malaria infection |
title_sort |
diagnosis and treatment based on quantitative pcr after controlled human malaria infection |
publisher |
BMC |
publishDate |
2016 |
url |
https://doi.org/10.1186/s12936-016-1434-z https://doaj.org/article/2d22cdb3f16e44c5a0b6794fd861c5a4 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 15, Iss 1, Pp 1-7 (2016) |
op_relation |
http://link.springer.com/article/10.1186/s12936-016-1434-z https://doaj.org/toc/1475-2875 doi:10.1186/s12936-016-1434-z 1475-2875 https://doaj.org/article/2d22cdb3f16e44c5a0b6794fd861c5a4 |
op_doi |
https://doi.org/10.1186/s12936-016-1434-z |
container_title |
Malaria Journal |
container_volume |
15 |
container_issue |
1 |
_version_ |
1766340938623352832 |