Comparative study of plasmodium lactate dehydrogenase (pldh) levels in malarial patients in coastal andhra pradesh region

Despite major control efforts, malaria remains a major public health problem that still causes high mortality rate worldwide especially in Africa and Asia. Accurate and confirmatory diagnosis before treatment initiation is the only way to control the disease. The present study was undertaken to evaluate the diagnostic technique sandwich ELISA for the detection of pLDH (plasmodium lactate dehydrogenase) antigen in proven malaria cases. Microscopic examination of blood smears remains the gold standard for the diagnosis of malaria. However it is labor- intensive and requires the skilled operators.
The differentiation of malarial parasites is based on the antigenic differences between the
pLDH isoforms. The pLDH assay was performed on all the samples according to the Qualisa manufacturer’s instructions. This study was designed to assess the sensitivity and specificity of pLDH assays in detecting and differentiating between various malarial species compared with microscopy. blood samples were provided by King George Hospital, visakhapatnam for our laboratory for routine diagnosis of malaria were included in this study. From each blood sample, thin films and a Quantitative buffy coat (QBC) were made for microscopy. Thin films were stained with Giemsa. Our data demonstrate that pLDH assay, given its accuracy, rapidity, ease of performance and interpretation can be a useful tool for the detection of malaria. However the PCR test with three primer sets was able to detect as few as four parasites per microliter by gel electrophoresis. The primer sets used in this technique were specified in BLAST analysis. Our comparative study of Microscopy, pLDH antigen ELISA and PCR test showed that the results obtained by PCR were equivalent and superior to those obtained by Microscopy.