Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria
Abstract Background Between 10,000 and 12,000 cases of imported malaria are notified in the European Union each year. Despite an excellent health care system, fatalities do occur. In case of advanced autolysis, the post-mortem diagnostic is impaired. Quicker diagnosis could be achieved by using rapi...
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ftdoajarticles:oai:doaj.org/article:9c8b510bf2e447e283458c1bfde30e66 2023-05-15T15:14:13+02:00 Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria Fleischmann Erna Sinicina Inga Berens-Riha Nicole Löscher Thomas 2009-10-01T00:00:00Z https://doi.org/10.1186/1475-2875-8-244 https://doaj.org/article/9c8b510bf2e447e283458c1bfde30e66 EN eng BMC http://www.malariajournal.com/content/8/1/244 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-8-244 1475-2875 https://doaj.org/article/9c8b510bf2e447e283458c1bfde30e66 Malaria Journal, Vol 8, Iss 1, p 244 (2009) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2009 ftdoajarticles https://doi.org/10.1186/1475-2875-8-244 2022-12-31T12:59:02Z Abstract Background Between 10,000 and 12,000 cases of imported malaria are notified in the European Union each year. Despite an excellent health care system, fatalities do occur. In case of advanced autolysis, the post-mortem diagnostic is impaired. Quicker diagnosis could be achieved by using rapid diagnostic malaria tests. Methods In order to evaluate different methods for the post-mortem diagnosis of Plasmodium falciparum malaria in non-immunes, a study was performed on the basis of forensic autopsies of corpses examined at variable intervals after death in five cases of fatal malaria (with an interval of four hours to five days), and in 20 cases of deaths unrelated to malaria. Detection of parasite DNA by PCR and an immunochromatographic test (ICT) based upon the detection of P. falciparum histidine-rich protein 2 (PfHRP2) were compared with the results of microscopic examination of smears from cadaveric blood, histopathological findings, and autopsy results. Results In all cases of fatal malaria, post-mortem findings were unsuspicious for the final diagnosis, and autoptic investigations, including histopathology, were only performed because of additional information by police officers and neighbours. Macroscopic findings during autopsy were unspecific. Histopathology confirmed sequestration of erythrocytes and pigment in macrophages in most organs in four patients (not evaluable in one patient due to autolysis). Microscopy of cadaveric blood smears revealed remnants of intraerythrocytic parasites, and was compromised or impossible due to autolysis in two cases. PCR and ICT performed with cadaveric blood were positive in all malaria patients and negative in all controls. Conclusion In non-immune fatalities with unclear anamnesis, ICT can be recommended as a sensitive and specific tool for post-mortem malaria diagnosis, which is easier and faster than microscopy, and also applicable when microscopic examination is impossible due to autolysis. PCR is more expensive and time-consuming, but may be used as ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 8 1 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Fleischmann Erna Sinicina Inga Berens-Riha Nicole Löscher Thomas Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Between 10,000 and 12,000 cases of imported malaria are notified in the European Union each year. Despite an excellent health care system, fatalities do occur. In case of advanced autolysis, the post-mortem diagnostic is impaired. Quicker diagnosis could be achieved by using rapid diagnostic malaria tests. Methods In order to evaluate different methods for the post-mortem diagnosis of Plasmodium falciparum malaria in non-immunes, a study was performed on the basis of forensic autopsies of corpses examined at variable intervals after death in five cases of fatal malaria (with an interval of four hours to five days), and in 20 cases of deaths unrelated to malaria. Detection of parasite DNA by PCR and an immunochromatographic test (ICT) based upon the detection of P. falciparum histidine-rich protein 2 (PfHRP2) were compared with the results of microscopic examination of smears from cadaveric blood, histopathological findings, and autopsy results. Results In all cases of fatal malaria, post-mortem findings were unsuspicious for the final diagnosis, and autoptic investigations, including histopathology, were only performed because of additional information by police officers and neighbours. Macroscopic findings during autopsy were unspecific. Histopathology confirmed sequestration of erythrocytes and pigment in macrophages in most organs in four patients (not evaluable in one patient due to autolysis). Microscopy of cadaveric blood smears revealed remnants of intraerythrocytic parasites, and was compromised or impossible due to autolysis in two cases. PCR and ICT performed with cadaveric blood were positive in all malaria patients and negative in all controls. Conclusion In non-immune fatalities with unclear anamnesis, ICT can be recommended as a sensitive and specific tool for post-mortem malaria diagnosis, which is easier and faster than microscopy, and also applicable when microscopic examination is impossible due to autolysis. PCR is more expensive and time-consuming, but may be used as ... |
format |
Article in Journal/Newspaper |
author |
Fleischmann Erna Sinicina Inga Berens-Riha Nicole Löscher Thomas |
author_facet |
Fleischmann Erna Sinicina Inga Berens-Riha Nicole Löscher Thomas |
author_sort |
Fleischmann Erna |
title |
Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
title_short |
Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
title_full |
Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
title_fullStr |
Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
title_full_unstemmed |
Comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
title_sort |
comparison of different methods for delayed post-mortem diagnosis of falciparum malaria |
publisher |
BMC |
publishDate |
2009 |
url |
https://doi.org/10.1186/1475-2875-8-244 https://doaj.org/article/9c8b510bf2e447e283458c1bfde30e66 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 8, Iss 1, p 244 (2009) |
op_relation |
http://www.malariajournal.com/content/8/1/244 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-8-244 1475-2875 https://doaj.org/article/9c8b510bf2e447e283458c1bfde30e66 |
op_doi |
https://doi.org/10.1186/1475-2875-8-244 |
container_title |
Malaria Journal |
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8 |
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1 |
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1766344693004632064 |