Department of Zoology, Faculty of Science, University of Khartoum, P.O. Box 321, Khartoum, Sudan.
Diagn Microbiol Infect Dis. 2011 Jun;70(2):207-12. doi: 10.1016/j.diagmicrobio.2011.01.007. Epub 2011 Mar 12.
In this study, 101 patients with massive splenomegaly (MS) and 41 with moderate splenomegaly (MoS) from Kassala, Eastern Sudan, were included. The patients were recruited during a peak and the end of a malaria season and during a dry season between 2007 and 2008. Based on clinical findings and exclusion of other causes of MS, the former patients were presumed to be infected with malaria parasite; thus, the condition was termed as massive malarial splenomegaly (MMS). Rapid diagnostic test (RDT) and polymerase chain reaction (PCR) were used for malaria parasite detection. In the MMS group, the parasite rate was 50% and 49% as estimated by microscopy and RDT, respectively. However, the PCR showed higher parasite rate (79.3%, P = 0.000), Plasmodium vivax infection, and mixed infections. The PCR-corrected parasite rate in the MoS and control groups was 73.2% and 3.5%, respectively. The parasite rate as estimated by microscopy was highest at the end of the malaria season and lowest in the dry season; however, the parasite rate estimated by PCR was stable in all study periods. There was significant reduction in spleen size following anti-malaria treatment. In conclusion, the use of PCR had revealed significantly higher parasite rate, P. vivax, and mixed infections in MMS as compared to microscopy, while the RDT was found to be comparable to microscopy and is suggested to complement the use of the latter. The study also disclosed a seasonal variation of patent parasitemia with an overall low parasite count and scarce gametocytaemia in MMS.
在这项研究中，纳入了来自苏丹东部卡萨拉的 101 例巨脾症（MS）患者和 41 例中度脾肿大（MoS）患者。这些患者是在 2007 年至 2008 年期间疟疾高发期和结束时以及旱季招募的。根据临床发现并排除其他导致 MS 的原因，前者被认为感染了疟原虫；因此，这种情况被称为巨脾疟疾（MMS）。采用快速诊断试验（RDT）和聚合酶链反应（PCR）检测疟原虫。在 MMS 组中，显微镜和 RDT 估计的寄生虫率分别为 50%和 49%。然而，PCR 显示出更高的寄生虫率（79.3%，P=0.000）、间日疟原虫感染和混合感染。MoS 组和对照组经 PCR 校正的寄生虫率分别为 73.2%和 3.5%。显微镜估计的寄生虫率在疟疾高发期末最高，在旱季最低；然而，PCR 估计的寄生虫率在所有研究期间均保持稳定。抗疟治疗后脾脏大小显著缩小。总之，与显微镜相比，PCR 显示 MMS 中的寄生虫率、间日疟原虫和混合感染显著升高，而 RDT 与显微镜相当，建议作为后者的补充。该研究还揭示了 MMS 中带虫期的季节性变化，总体寄生虫计数较低，配子体血症稀少。
