Comparative evaluation of Plasmodium falciparum glutamate dehydrogenase with known Plasmodium falciparum diagnostic targets using quantitative real-time polymerase chain reaction.

内容摘要

Accurate diagnosis is crucial for early malaria treatment and for preventing its transmission. However, efforts to eliminate malaria face significant challenges, including limited treatment options and inadequate diagnostic tools for detecting Plasmodium falciparum (Pf) infections. This study evaluates P. falciparum glutamate dehydrogenase ( pfgdh ) as a novel diagnostic target, comparing its performance to established markers- pfhrp2, pfhrp3, pfaldolase , and pfldh for detecting Pf infections. A retrospective analysis of stored DNA samples was conducted using 150 Pf-positive samples and 50 malaria-negative samples, which were analysed by quantitative real-time polymerase chain reaction (qPCR). Sensitivity, Specificity, positive predictive value, negative 2 predictive value, and the area under the receiver operating characteristic (ROC) curve (AUC) were calculated for each gene, using a threshold cycle value of ≤37 as the cutoff. Sensitivities of pfhrp2, pfhrp3, pfgdh, pfaldolase , and pfldh were 72%, 71%, 69%, 29%, and 19%, respectively, while their specificities were 100%, 96%, 98%, 100%, and 100%, respectively. The AUC values, reflecting diagnostic predictivity, were 86%, 84%, 83%, 64%, and 60%, respectively. These findings suggest that pfgdh demonstrates notable diagnostic potential compared to the other genes. Its reliability as a target could help overcome challenges posed by pfhrp2 gene deletions, making pfgdh a promising alternative for detecting Pf .