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Volume 22, Number 2—February 2016
Dispatch

The Merits of Malaria Diagnostics during an Ebola Virus Disease Outbreak

Emmie de Wit, Darryl Falzarano1, Clayton Onyango, Kyle Rosenke, Andrea Marzi, Melvin Ochieng, Bonventure Juma, Robert J. Fischer, Joseph B. Prescott, David Safronetz2, Victor Omballa, Collins Owuor, Thomas Hoenen3, Allison Groseth3, Neeltje van Doremalen, Galina Zemtsova, Joshua Self, Trenton Bushmaker, Kristin McNally, Thomas Rowe, Shannon L. Emery, Friederike Feldmann, Brandi Williamson, Tolbert G. Nyenswah, Allen Grolla, James E. Strong, Gary Kobinger, Ute Stroeher, Mark Rayfield, Fatorma K. Bolay, Kathryn C. Zoon, Jorgen Stassijns, Livia Tampellini, Martin de Smet, Stuart T. Nichol, Barry Fields, Armand Sprecher, Heinz Feldmann, Moses Massaquoi, and Vincent J. MunsterComments to Author 
Author affiliations: National Institutes of Health, Hamilton, Montana, USA (E. de Wit, D. Falzarano, K. Rosenke, A. Marzi, R.J. Fischer, J.B. Prescott, D. Safronetz, T. Hoenen, A. Groseth, N. van Doremalen, T. Bushmaker, K. McNally, F. Feldmann, B. Williamson, H. Feldmann, V.J. Munster); Centers for Disease Control and Prevention, Nairobi, Kenya (C. Onyango, B. Juma, B. Fields); Kenya Medical Research Institute, Nairobi (M. Ochieng, V. Omballa, C. Owuor); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (G. Zemtsova, J. Self, T. Rowe, S.L. Emery, U. Stroeher, M. Rayfield, S.T. Nichol); Ministry of Health and Social Welfare, Monrovia, Liberia (T.G. Nyenswah, M. Massaquoi); Public Health Agency of Canada, Winnipeg, Manitoba, Canada (A. Grolla, J.E. Strong, G. Kobinger); Liberian Institute for Biomedical Research, Charlesville, Liberia (F.K. Bolay); National Institutes of Health, Bethesda, Maryland, USA (K.C. Zoon); Médecins Sans Frontières, Brussels, Belgium (J. Stassijns, L. Tampellini, M. de Smet, A. Sprecher)

Main Article

Figure 1

Prevalence of Ebola virus (EBOV) and Plasmodium spp. RNA in patient samples submitted to the Centers for Disease Control and Prevention–National Institutes of Health diagnostic laboratory at the Eternal Love Winning Africa campus in Monrovia, Liberia, from October 12, 2014 (epidemiologic week 42), through March 28, 2015 (week 13). Whole blood samples were inactivated, and RNA was extracted by using the QIAAmp Viral RNA Mini Kit (QIAGEN, Hilden, Germany). These samples were then tested for the pr

Figure 1. Prevalence of Ebola virus (EBOV) and Plasmodium spp. RNA in patient samples submitted to the Centers for Disease Control and Prevention–National Institutes of Health diagnostic laboratory at the Eternal Love Winning Africa campus in Monrovia, Liberia, from October 12, 2014 (epidemiologic week 42), through March 28, 2015 (week 13). Whole blood samples were inactivated, and RNA was extracted by using the QIAAmp Viral RNA Mini Kit (QIAGEN, Hilden, Germany). These samples were then tested for the presence of EBOV RNA and Plasmodium spp. RNA by real-time quantitative reverse transcription PCR (qRT-PCR) (13). A) Number of patients, as determined by qRT-PCR, positive for EBOV, Plasmodium spp., both, or neither (i.e., no EBOV and no Plasmodium spp.), by epidemiologic week. B) Total number of patients receiving a laboratory diagnosis of Ebola viremia, Plasmodium spp. parasitemia, both, or neither. C) A subset of 311 Plasmodium spp. qRT-PCR–positive samples that were retested with a qRT-PCR specific for P. falciparum (14).

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References
  1. World Health Organization. Ebola situation report. 2015 October 28 [cited 2015 Oct 28]. http://apps.who.int/iris/bitstream/10665/191299/1/ebolasitrep_28Oct2015_eng.pdf?ua=1
  2. Plucinski  MM, Guilavogui  T, Sidikiba  S, Diakité  N, Diakité  S, Dioubaté  M, Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities. Lancet Infect Dis. 2015;15:101723 .DOIPubMedGoogle Scholar
  3. Check Hayden  E. Ebola obstructs malaria control. Nature. 2014;514:156 .DOIPubMedGoogle Scholar
  4. Mobula  ML, Brown  CA, Burnham  G, Phelps  BR. Need for reinforced strategies to support delivery of HIV clinical services during the Ebola outbreak in Guinea, Liberia, and Sierra Leone. Disaster Med Public Health Prep. 2015;9:5226 .DOIPubMedGoogle Scholar
  5. Takahashi  S, Metcalf  CJ, Ferrari  MJ, Moss  WJ, Truelove  SA, Tatem  AJ, Reduced vaccination and the risk of measles and other childhood infections post-Ebola. Science. 2015;347:12402 .DOIPubMedGoogle Scholar
  6. United Nations Population Fund. Ebola wiping out gains in safe motherhood [press release]. 16 October 2014 [cited 2015 Oct 28]. http://www.unfpa.org/news/ebola-wiping-out-gains-safe-motherhood
  7. Walker  PG, White  MT, Griffin  JT, Reynolds  A, Ferguson  NM, Ghani  AC. Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis. Lancet Infect Dis. 2015;15:82532 .DOIPubMedGoogle Scholar
  8. World Health Organization. World malaria report 2014 [cited 2015 Oct 28]. http://www.who.int/malaria/publications/world_malaria_report_2014/report/en
  9. Centers for Disease Control and Prevention. Recommendations for managing and preventing cases of malaria in areas with Ebola. 2015 [cited 2015 Oct 28]. http://www.cdc.gov/vhf/ebola/outbreaks/malaria-cases.html
  10. Sterk  E. Filovirus haemorrhagic fever guideline. Barcelona, Spain: Médecins Sans Frontières; 2008.
  11. Benito  A, Rubio  JM. Usefulness of seminested polymerase chain reaction for screening blood donors at risk for malaria in Spain. Emerg Infect Dis. 2001;7:1068 .DOIPubMedGoogle Scholar
  12. Centers for Disease Control and Prevention. DPDx: laboratory identification of parasitic diseases of public health concern. 2015 [cited 2015 Oct 28]. http://www.cdc.gov/dpdx/diagnosticProcedures/blood/antigendetection.html
  13. Lee  MA, Tan  CH, Aw  LT, Tang  CS, Singh  M, Lee  SH, Real-time fluorescence-based PCR for detection of malaria parasites. J Clin Microbiol. 2002;40:43435 .DOIPubMedGoogle Scholar
  14. Shokoples  SE, Ndao  M, Kowalewska-Grochowska  K, Yanow  SK. Multiplexed real-time PCR assay for discrimination of Plasmodium species with improved sensitivity for mixed infections. J Clin Microbiol. 2009;47:97580 .DOIPubMedGoogle Scholar
  15. O’Shea  MK, Clay  KA, Craig  DG, Matthews  SW, Kao  RL, Fletcher  TE, Diagnosis of febrile illnesses other than Ebola virus disease at an Ebola treatment unit in Sierra Leone. Clin Infect Dis. 2015;61:7958 .DOIPubMedGoogle Scholar

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1Current affiliation: University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

2Current affiliation: Public Health Agency of Canada, Winnipeg, Manitoba, Canada.

3Current affiliation: Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany.

Page created: January 15, 2016
Page updated: January 15, 2016
Page reviewed: January 15, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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