Diagnosis of malaria in the field by fluorescence microscopy of QBC® capillary tubes

Abstract

The diagnostic performance of commercial capillary tubes containing acridine orange dye (QBC) was compared with the standard diagnosis of malaria by microscopical examination of Giemsa-stained thick blood films (GTS) in remote field conditions. The comparison was conducted among 165 volunteers living in northeastern Irian Jaya, Indonesia, an area having hyperendemic malaria transmission. By GTS, 65 volunteers were positive for malaria, but only 49 were judged positive by QBC. Among the 100 blood films found negative by GTS, 5 were considered positive by QBC. Thus, relative to a GTS standard, the sensitivity and specificity of the QBC was 75% and 95%, respectively. The mean limit of detection for the QBC was approximately 60 parasites per microliter blood, whereas the limit of detection for GTS was 20 parasites per microliter blood. Also, a number of practical difficulties were encountered using the QBC at the field site. The QBC approach to diagnosis of malaria was less sensitive and more inconvenient than GTS under the conditions in remote Irian Jaya.