Validation of microscopic diagnosis of malaria in field laboratories of malarious areas of Iran by Nested PCR

Examination of Geimsa stained blood smears is the main method of malaria diagnosis in our country, however, accuracy of results is largely depended on the skill and laboratory conditions. This study was designed and carried out to assess the current situation and to determine the effectiveness and quality improvement of malaria diagnosis program. In this analytical study, 100 positive blood samples for malaria by microscopic method (85 Plasmodium vivax and 15 Plasmodium falciparum) and 15 negative samples were collected from malarious areas of Iran and processed by Nested PCR to amplify the ssrRNA (small sub-unit ribosomal RNA). Kappa agreement coefficient was calculated by SPSS software. Except for one case, diagnosis either by microscopic or Nested-PCR was the same. The exception was for one case diagnosed Plasmodium falciparum by microscopic and in agreement method whiteas mix infection (Plasmodium vivax and Plasmodium falciparum) by Nested-PCR. Agreement coefficient of microscopic and Nested-PCR methods was high. In contrast to previous studies, high agreement coefficient of microscopic and Nested-PCR methods in this study indicates, the effectiveness of quality improvement of malaria diagnosis program in Iran.