Low Prevalence of Plasmodium vivax - Plasmodium falciparum Mixed - Infection in Patients from Central and Eastern Part of Sudan: Implication for Case Management in Sudan

Abstract

Accurate diagnosis of malaria parasite species is crucial for rational treatment that is a key success for a malaria control and elimination programmes. The main objective of this investigation was to correct species identification and re-assessment of diagnosis method in central and eastern part of Sudan. The blood samples were collected from 71 febrile cases infected with P. vivax in Eastern and Central Sudan, diagnosed by light microscopy and also by nested-PCR assay, using 18S small sub-unit ribosomal RNA (ssrRNA) gene. The nested-PCR were detect 92.9% (66/71) and 2.8% (2/71) P. vivax and P. falciparum mono-infection, respectively. Based on microscopy method, the level of mixed - Infection was zero; however, nested-PCR assay detected 4.2% (3/71) mixed infections in collected samples. In detecting P. vivax infection, microscopy had high sensitivity (97%) and specificity (50%). In conclusion, the present data point to the need of improving microscopy diagnosis method in malaria endemic region and also suggest that although molecular techniques are not practical for diagnosis of P. vivax and P. falciparum mixed infections in any areas; these could be used to collect epidemiological facts for control and elimination of the disease in Sudan.