Molecular Diagnosis of Malaria Infection: A Survey in a Hospital in Central Italy

Malaria is a dramatic disease caused by the protozoan parasites Plasmodium. The diagnosis is mainly based on microscopy and rapid diagnostic tests (RDT). Molecular approaches based on PCR techniques may be an alternative tool particularly favourable in regions with declining prevalence. This work aimed to assess pros and cons of molecular diagnosis of malaria in a district of Central Italy were several tens of imported malaria cases are diagnosed every year. Thirty-three blood samples were analysed by microscopy, RDT and molecular techniques to monitor the relative efficiency in malaria diagnosis. Molecular analysis and microscopy diagnosed 32 out of 33 samples as positive for malaria, while RDT only 29. More differences concerned the diagnosis of mixed infections. Our findings remark the importance of the molecular approach in supporting and improving malaria diagnosis. In the cases here presented, the molecular analysis was particularly useful to unveil parasites presence in infections not detectable by blood smear analysis and to additionally solve real and/or presumed mixed infections.