Korean J Parasitol.  2019 Jun;57(3):233-242. 10.3347/kjp.2019.57.3.233.

Malaria Prevalence in a Low Transmission Area, Jazan District of Southwestern Saudi Arabia

Affiliations
  • 1Clinical Laboratories Sciences Department, College of Applied Medical Science, Taif University, Taif, Saudi Arabia. yousryhawash@gmail.com
  • 2Parasitology Department, National Liver Institute, Menoufia University, Menoufia, Egypt.
  • 3Parasitology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Abstract

Detailed description of malaria in low transmission areas is crucial for elimination. The current study aimed to provide a comprehensive description for malaria transmission in Jazan, a low transmission district, southwestern Saudi Arabia. Patients at a tertiary care hospital were recruited in our study between August 2016 and September 2018. Malaria diagnosis was performed through a species-specific nested polymerase chain reaction (nested PCR), microscopy and Paramax-3â„¢ rapid detection test (RDT). Malaria was detected in 30 patients by the PCR, with point prevalence of 10.9%. Of these malaria infections, 80% was imported, 26.6% was asymptomatic and 23.3% was sub-microscopic. Malaria was reported throughout the year, with February/March and September/October peaks. Infection was significantly more in males than in females (P=0.01). Likewise, infections were detected more in febrile than in non-febrile patients (P=0.01). Adult aged 15-24 years, fever and travel were identified as high-risk factors. Malaria was primarily attributed to Plasmodium falciparum mono-infections, followed by P. vivax mono-infections and lastly to falciparum/vivax mixed infections accounting 76.6%, 16.6%, and 6.6% of PCR-confirmed malaria cases, respectively. The nested PCR was superior to the smear microscopy (sensitivity 76.6%; specificity 100%) and the RDT (sensitivity 83.3%, specificity 94.2%). The overall percent agreement between microscopy and the RDT was 92.7% (kappa=0.63). High proportion of imported malaria including sub-microscopic and sub-patent cases were described. We suggest that incorporation of molecular tool into the conventional malaria diagnosis is beneficial in Jazan district.

Keyword

Malaria diagnosis; nested PCR; Paramax-3â„¢; sub-microscopic/asymptomatic infections; Saudi Arabia

MeSH Terms

Adult
Coinfection
Diagnosis
Female
Fever
Humans
Malaria*
Male
Microscopy
Plasmodium falciparum
Polymerase Chain Reaction
Prevalence*
Saudi Arabia*
Sensitivity and Specificity
Tertiary Healthcare
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