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Table 4 Seven samples (six patients) with discordant results between the different methods

From: A novel, single-amplification PCR targeting mitochondrial genome highly sensitive and specific in diagnosing malaria among returned travellers in Bergen, Norway

Patient

Microscopy

Parasitaemia by microscopy

18S PCR assays

Mitochondrial PCR/sequencing

Primary/recurrent infection

Place of infection

Interpretation

P 1

Negative

01

Pm

Pm

Primary

Ghana

Pm overlooked by microscopy

P 2

Negative2

01

Pv

Pv

Primary

New Guinea

Pv overlooked by microscopy

P 2

Pf, Pv

or Pk

1%

Pv

Pv

Recurrent (Relapse)

New Guinea

Inconclusive/ incorrect diagnosis by microscopy

P 3

Pf + Po

<1%

Po

Po

Recurrent (Relapse)

Uganda

Over-diagnosed mixed infection by microscopy

P 4

Pf

<1%

Pf + Pm

Pf

Primary

Liberia

Under-diagnosed mixed infection by microscopy/sequencing

P 5

Pf + Pv

1%

Pv

Pv

Primary3

SEA or CA

Over-diagnosed mixed infection by microscopy

P 6

Pf 4

<1%

Negative

Pf

Recurrent (Recrudescence)

Guinea

Un-detected low Pf parasitaemia by 18S PCR

  1. Abbreviations: Pf, Plasmodium falciparum; Pv, Plasmodium vivax; Po, Plasmodium ovale; Pm, Plasmodium malariae; Pk, Plasmodium knowlesi; SEA, South east Asia; CA, Central America.
  2. 1 Not detected any parasites.
  3. 2 Positive microscopy two days later (1% parasitaemia) and then the patient was diagnosed with severe malaria and treatment initiated.
  4. 3 Not given hypnozoite-eradicating treatment and re-admitted four weeks later with relapse of Plasmodium vivax.
  5. 4 Only one parasite detected.