Ghayour Najafabadi Zahra, Oormazdi Hormozd, Akhlaghi Lame, Meamar Ahmad Reza, Raeisi Ahmad, Rampisheh Zahra, Nateghpour Mehdi, Razmjou Elham
Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Trans R Soc Trop Med Hyg. 2014 Jun;108(6):358-62. doi: 10.1093/trstmh/tru061. Epub 2014 Apr 25.
Malaria can be diagnosed in saliva and urine using mitochondrial PCR detection of Plasmodium DNA.
Blood, saliva and urine were collected from 99 febrile patients referred to health centers in Sistan and Baluchestan Province, southeastern Iran, from May to November 2011. The mitochondrial cytochrome b gene of Plasmodium falciparum and Plasmodium vivax was targeted in saliva, urine and blood samples using nested PCR.
Nested PCR proved to be more sensitive than microscopy for the diagnosis of sub-microscopic and mixed-species infections. The results of nested PCR amplifications of saliva and urine samples showed the same specificity of 97% and sensitivity of 91% and 70%, respectively. Nested PCR amplifications of saliva samples and microscopy showed the greatest area under the receiver operating characteristic (ROC) curve and were more accurate than nested PCR amplifications of urine samples.
Nested PCR amplification of saliva samples showed good levels of detection of mitochondrial Plasmodium DNA as compared to nested PCR of blood (к=0.84; AUC=0.94), which was used as a reference standard. Based on the results of nested PCR as well as the advantages of saliva sampling, we suggest that saliva could be an alternative to blood, in malaria diagnosis, in cases where repeat sampling is required. Further studies are needed to validate these findings.
可通过对疟原虫DNA进行线粒体PCR检测，在唾液和尿液中诊断疟疾。
2011年5月至11月，从伊朗东南部锡斯坦-俾路支斯坦省卫生中心转诊的99名发热患者中采集血液、唾液和尿液。使用巢式PCR对唾液、尿液和血液样本中的恶性疟原虫和间日疟原虫的线粒体细胞色素b基因进行靶向检测。
巢式PCR在诊断亚显微感染和混合物种感染方面比显微镜检查更敏感。唾液和尿液样本的巢式PCR扩增结果显示，特异性均为97%，敏感性分别为91%和70%。唾液样本的巢式PCR扩增和显微镜检查在受试者工作特征（ROC）曲线下面积最大，比尿液样本的巢式PCR扩增更准确。
与作为参考标准的血液巢式PCR相比，唾液样本的巢式PCR扩增显示出线粒体疟原虫DNA的良好检测水平（к=0.84；AUC=0.94）。基于巢式PCR的结果以及唾液采样的优势，我们建议在需要重复采样的情况下，唾液可作为疟疾诊断中血液的替代样本。需要进一步研究来验证这些发现。
