Epidemiology of Plasmodium infections in Flores Island, Indonesia using real-time PCR

Maria Mm Kaisar, Taniawati Supali, Aprilianto E. Wiria, Firdaus Hamid, Linda J. Wammes, Erliyani Sartono, Adrian Jf Luty, Eric At Brienen, Maria Yazdanbakhsh, Lisette Van Lieshout, Jaco J. Verweij

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21 Citations (Scopus)


Background: DNA-based diagnostic methods have been shown to be highly sensitive and specific for the detection of malaria. An 18S-rRNA-based, real-time polymerase chain reaction (PCR) was used to determine the prevalence and intensity of Plasmodium infections on Flores Island, Indonesia. Methods. Microscopy and real-time multiplex PCR for the detection of Plasmodium species was performed on blood samples collected in a population-based study in Nangapanda Flores Island, Indonesia. Results: A total 1,509 blood samples were analysed. Real-time PCR revealed prevalence for Plasmodium falciparum, Plasmodium vivax, and Plasmodium malariae to be 14.5%, 13.2%, and 1.9% respectively. Sub-microscopic parasitaemia were found in more than 80% of all positive cases. The prevalence of P. falciparum and P. vivax was significantly higher in subjects younger than 20 years (p ≤ 0.01). In the present study, among non-symptomatic healthy individuals, anaemia was strongly correlated with the prevalence and load of P. falciparum infections (p ≤ 0.01; p = 0.02) and with the load of P. vivax infections (p = 0.01) as detected with real-time PCR. Subjects with AB blood group tend to have a higher risk of being infected with P. falciparum and P. vivax when compared to other blood groups. Conclusion: The present study has shown that real-time PCR provides more insight in the epidemiology of Plasmodium infections and can be used as a monitoring tool in the battle against malaria. The unsurpassed sensitivity of real-time PCR reveals that sub microscopic infections are common in this area, which are likely to play an important role in transmission and control. Trial registration. Trials number ISRCTN83830814.

Original languageEnglish
Article number169
JournalMalaria Journal
Issue number1
Publication statusPublished - 2013


  • Diagnosis
  • Flores
  • Malaria
  • Plasmodium falciparum
  • Plasmodium malariae
  • Plasmodium vivax
  • Real-time PCR


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