{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:25:31Z","timestamp":1785223531571,"version":"3.55.0"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,3]]},"abstract":"<jats:p>Estimates of malaria transmission intensity (MTI) typically rely upon microscopy or rapid diagnostic testing (RDT). However, these methods are less sensitive than nucleic acid amplification techniques and may underestimate parasite prevalence. We compared microscopy, RDT, and polymerase chain reaction (PCR) for the diagnosis of <jats:italic>Plasmodium falciparum<\/jats:italic> parasitemia as part of an MTI study of 800 children and adults conducted in Lilongwe, Malawi. PCR detected more cases of parasitemia than microscopy or RDT. Age less than 5 years predicted parasitemia detected by PCR alone (adjusted odds ratio = 1.61, 95% confidence interval = 1.09\u20132.38, Wald <jats:italic>P<\/jats:italic> = 0.02). In addition, we identified one <jats:italic>P. falciparum<\/jats:italic> parasite with a false-negative RDT result due to a suspected deletion of the histidine-rich protein 2 (<jats:italic>hrp2<\/jats:italic>) gene and used a novel, ultrasensitive PCR assay to detect low-level parasitemia missed by traditional PCR. Molecular methods should be considered for use in future transmission studies as a supplement to RDT or microscopy.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0156","type":"journal-article","created":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T03:28:40Z","timestamp":1466479720000},"page":"373-377","source":"Crossref","is-referenced-by-count":19,"title":["Estimation of Plasmodium falciparum Transmission Intensity in Lilongwe, Malawi, by Microscopy, Rapid Diagnostic Testing, and Nucleic Acid Detection"],"prefix":"10.4269","volume":"95","author":[{"given":"Jonathan B.","family":"Parr","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor","family":"Belson","sequence":"additional","affiliation":[{"name":"2Department of Biology, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymin C.","family":"Patel","sequence":"additional","affiliation":[{"name":"3Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irving F.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina."},{"name":"4University of North Carolina Project-Malawi, Lilongwe, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Portia","family":"Kamthunzi","sequence":"additional","affiliation":[{"name":"4University of North Carolina Project-Malawi, Lilongwe, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Martinson","sequence":"additional","affiliation":[{"name":"4University of North Carolina Project-Malawi, Lilongwe, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Tegha","sequence":"additional","affiliation":[{"name":"4University of North Carolina Project-Malawi, Lilongwe, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Thengolose","sequence":"additional","affiliation":[{"name":"4University of North Carolina Project-Malawi, Lilongwe, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Drakeley","sequence":"additional","affiliation":[{"name":"5London School of Hygiene and Tropical Medicine, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Meshnick","sequence":"additional","affiliation":[{"name":"3Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Escamillia","sequence":"additional","affiliation":[{"name":"6Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Emch","sequence":"additional","affiliation":[{"name":"7Department of Geography, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina."},{"name":"3Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina."},{"name":"8Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"World Malaria Report 2014","author":"World Health Organization","year":"2014"},{"key":"ref2","series-title":"Lancet","first-page":"31","article-title":"Efficacy and safety of RTS,S\/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial","volume":"386","author":"RTS,S Clinical Trials Partnership","year":"2015"},{"key":"ref3","series-title":"Malar J","first-page":"433","article-title":"Comparison of detection methods to estimate asexual Plasmodium falciparum parasite prevalence and gametocyte carriage in a community survey in Tanzania","volume":"13","author":"Mwingira","year":"2014"},{"key":"ref4","series-title":"Trop Med Int Health","first-page":"3","article-title":"Reliability of malaria microscopy in epidemiological studies: results of quality control","volume":"5","author":"Kilian","year":"2000"},{"key":"ref5","series-title":"Malaria Rapid Diagnostic Test Performance. 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