Identification and determination of malaria infection in asymptomatic persons in endemic Area of southeast in Iran

Mirahmadi, Hadi; Azizi, Seyed Ghader; Salimikhorashad, Alireza; Yousefnia, Hossein; Raeghi, Saber; Solgi, Rahmat

doi:10.22092/ari.2026.364131.2940

Identification and determination of malaria infection in asymptomatic persons in endemic Area of southeast in Iran

Articles in Press

Document Type : Original Articles

Authors

¹ Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

² Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

³ PhD student, Department of Medical Parasitology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

⁴ Department of Laboratory Sciences, Maragheh University of Medical Sciences, Maragheh, Iran

⁵ Birjand University of Medical Sciences

10.22092/ari.2026.364131.2940

Abstract

The presence of symptomless malaria infection in endemic areas and misdiagnosis can lead to failure in malaria eradication strategies. The present study was performed to assessment the prevalence of asymptomatic carriers in the Saravan and Suran district, an endemic area of malaria infection in Sistan and Baluchistan Province (2019-2024). In the present study, the samples (n=985) were collected from asymptomatic person of Saravan and Suran district of Iran for assessment malaria infection by using microscopic, ELISA, RDT test, multiplex nested-PCR and LAMP techniques. All study samples were categorized by sex and age group. Sampling was performed during July 2019 to March 2024. The microscopic and RDT tests were negative for malaria infection. Based on MSP1₁₉ kDa-ELISA test for detection of malaria-specific antibodies, 5 and 68 out of 985 samples was positive for P. falciparum and P.vivax antibodies, respectively. The multiplex nested-PCR and LAMP techniques could detect only 6 and 7 cases of P. vivax, respectively. These results suggest that among the 985 samples tested, there was a low prevalence of malaria infection. It is important to note that negative results from the microscopic and RDT tests do not completely rule out malaria infection, as these tests have limitations in their sensitivity and ability to detect low parasite levels. Despite the higher number of antibody-positive cases detected by ELISA, the molecular methods demonstrated superior diagnostic value by specifically identifying active P. vivax infections, highlighting their greater specificity and ability to distinguish current parasitemia from past. Further analysis and testing may be needed to fully understand the prevalence and distribution of the P. falciparum and P. vivax species in the studied population.

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