TY - JOUR
T1 - A novel sensitive hexaplex high-resolution melt assay for identification of five human Plasmodium species plus internal control
AU - Srisutham, Suttipat
AU - Rattanakoch, Paweesuda
AU - Kijprasong, Kaewkanha
AU - Sugaram, Rungniran
AU - Kantaratanakul, Nantanat
AU - Srinulgray, Theerarak
AU - Dondorp, Arjen M.
AU - Imwong, Mallika
N1 - Funding Information: This Research is funded by Thailand Science research and Innovation Fund Chulalongkorn University ( HEA663700102 ), Grants for development of new faculty staff, Ratchadapisek Somphot Fund, Chulalongkorn University. Research funds of Faculty of Allied Health Sciences, Chulalongkorn University. This research project was also supported by Mahidol University , MU-MRC to MI, and part of the Mahidol-University Oxford Tropical Medicine Research Programme funded by the Wellcome Trust of the United Kingdom (core grant 106698/B/14/Z ) and Wellcome OA statement. This research was funded in whole, or in part, by the Wellcome Trust [ 220211 ]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. The funding sources did not participate in data analysis or the final decision to publish the manuscript. Publisher Copyright: © 2023
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: The diagnosis of malaria infection in humans remains challenging, further complicated by mixed Plasmodium species infections, potentially altering disease severity and morbidity. To facilitate appropriate control measures and treatment, rapid, sensitive, and specific detection assays, including those for the second minor species, would be required. This study aimed to develop a multiplex high-resolution melting (hexaplex PCR-HRM) assay with seven distinct peaks corresponding to five Plasmodium species of the Plasmodium genus, and an internal control to limit false negatives providing quality assurance testing results. Methods: Five species-specific primers for human malaria species were designed targeting on the Plasmodium 18 small subunit ribosomal RNA (18S rRNA) and mitochondrial genes. The hexaplex PCR-HRM was developed for the simultaneous and rapid detection and differentiation of five human Plasmodium spp. The limit of detection (LoD), sensitivity, and specificity of the assay were evaluated. Artificial mixing was used to assess the ability to determine the second minor species. Furthermore, a hexaplex PCR-HRM assay was used to identify 120 Plasmodium-infected clinical isolates from Kanchanaburi, Western Thailand, where malaria is endemic. Results: The hexaplex PCR-HRM assay detected the targeted genome of five Plasmodium species at levels as low as 2.354–3.316 copies/uL with 91.76 % sensitivity and 98.04 % specificity. In artificial mixing, the assay could detect minority parasite species at 0.001 % of the predominant parasite population. Plasmodium vivax infections (99 %) accounted for the majority of malaria cases in Kanchanaburi, Thailand. Conclusions: The developed hexaplex PCR-HRM assay we present in this study is a novel approach for multiplexing the Plasmodium genus and detecting five Plasmodium species with the advantage of detecting second minority parasite species. The developed one-step assay without any nesting protocols would reduce the risks of cross-contamination. Moreover, it also provides a simple, sensitive, specific, and low-cost approach for optional molecular detection of malaria.
AB - Background: The diagnosis of malaria infection in humans remains challenging, further complicated by mixed Plasmodium species infections, potentially altering disease severity and morbidity. To facilitate appropriate control measures and treatment, rapid, sensitive, and specific detection assays, including those for the second minor species, would be required. This study aimed to develop a multiplex high-resolution melting (hexaplex PCR-HRM) assay with seven distinct peaks corresponding to five Plasmodium species of the Plasmodium genus, and an internal control to limit false negatives providing quality assurance testing results. Methods: Five species-specific primers for human malaria species were designed targeting on the Plasmodium 18 small subunit ribosomal RNA (18S rRNA) and mitochondrial genes. The hexaplex PCR-HRM was developed for the simultaneous and rapid detection and differentiation of five human Plasmodium spp. The limit of detection (LoD), sensitivity, and specificity of the assay were evaluated. Artificial mixing was used to assess the ability to determine the second minor species. Furthermore, a hexaplex PCR-HRM assay was used to identify 120 Plasmodium-infected clinical isolates from Kanchanaburi, Western Thailand, where malaria is endemic. Results: The hexaplex PCR-HRM assay detected the targeted genome of five Plasmodium species at levels as low as 2.354–3.316 copies/uL with 91.76 % sensitivity and 98.04 % specificity. In artificial mixing, the assay could detect minority parasite species at 0.001 % of the predominant parasite population. Plasmodium vivax infections (99 %) accounted for the majority of malaria cases in Kanchanaburi, Thailand. Conclusions: The developed hexaplex PCR-HRM assay we present in this study is a novel approach for multiplexing the Plasmodium genus and detecting five Plasmodium species with the advantage of detecting second minority parasite species. The developed one-step assay without any nesting protocols would reduce the risks of cross-contamination. Moreover, it also provides a simple, sensitive, specific, and low-cost approach for optional molecular detection of malaria.
KW - Detection
KW - HRM
KW - Malaria
KW - PCR
KW - Plasmodium
UR - http://www.scopus.com/inward/record.url?scp=85172698466&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.actatropica.2023.107020
DO - https://doi.org/10.1016/j.actatropica.2023.107020
M3 - Article
C2 - 37739253
SN - 0001-706X
VL - 248
JO - Acta tropica
JF - Acta tropica
M1 - 107020
ER -