The usefulness of a quantitative olfactory test for the detection of COVID-19

AbstractBackgroundDuring the COVID-19 pandemic, olfactory dysfunction (anosmia or hyposmia) has been reported by many patients and recognized as a prevalent and early symptom of infection. This finding has been associated with viral-induced olfactory neuron dysfunction rather than the nasal congestion typically found in cold- or flu-like states. In literature, the prevalence of anosmia varies from 15% to 85%, and the studies, in general, were based on the subjective evaluation of patients’ self-reports of loss of smell (yes or no question). In the present study, we quantitatively evaluated olfactory dysfunction and the prevalence of fever in symptomatic patients suspected of having COVID-19 using a scratch-and-sniff olfactory test and infrared temperature testing with RT-PCR as the gold-standard comparator method to diagnose COVID-19 infection.MethodsOutpatients had their forehead temperature checked with an infrared non-contact thermometer (temperature guns). After that, they received two olfactory smell identification test (SIT) cards (u-Smell-it™; CT, USA) that each had 5 scent windows and were asked to scratch with a pencil and sniff each of the 10 small circles containing the microencapsulated fragrances and mark the best option on a response card. Nasopharyngeal swabs were then collected for Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) to determine if the patients were positive or negative for COVID-19 infection. We considered the number of ‘hits’ (correct answers) ≤ 5 as positive for loss of smell (LOS) in the olfactory test; ≥ 6 hits was considered negative for LOS (i.e. normal olfactory function). All data were analyzed using Excel and Matlab software.ResultsIn the present study, 165 patients were eligible for the olfactory test and nasopharyngeal swab collection RT-PCR. Five patients were excluded because of inconclusive PCR results (n=2) and missing data (n=3). A total of 160 patients completed all the protocols. The RT-PCR positivity rate for COVID-19 was 27.5% (n=44), and PCR+ patients scored significantly worse in the olfactory test (5.5±3.5) compared to RT-PCR-patients (8.2±1.8, p<0.001). 0/44 PCR+ patients presented with a fever (≥37.8°C). In contrast an olfactory SIT had a specificity of 94.8% (95% CI, 89.1 – 98.1), sensitivity of 47.7% (95% CI, 32.7 – 63.3), accuracy of 0.82 (95% CI, 0.75 – 0.87), positive predictive value of 77.8% (95% CI, 59.6 – 88.8), negative predictive value of 82.7% (85% CI, 78.7 – 86.7), and odds ratio of 16.7.ConclusionOur results suggest that temperature checking failed to detect COVID-19 infection, while an olfactory test may be useful to help identify COVID-19 infection in symptomatic patients.

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A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Scientific Reports ◽

10.1038/s41598-020-80061-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

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Inappropriate Nasopharyngeal Sampling for SARS-CoV-2 Detection Is a Relevant Cause of False-Negative Reports

Otolaryngology ◽

10.1177/0194599820931793 ◽

2020 ◽

Vol 163 (3) ◽

pp. 459-461 ◽

Cited By ~ 12

Author(s):

Antonio Piras ◽

Davide Rizzo ◽

Sergio Uzzau ◽

Giacomo De Riu ◽

Salvatore Rubino ◽

...

Keyword(s):

Nasal Obstruction ◽

Negative Impact ◽

Present Report ◽

False Negative ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Radiologic Findings ◽

Negative Findings ◽

Current Outbreak ◽

Polymerase Chain

Reverse transcriptase polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 mRNA on nasopharyngeal swab is the standard for diagnosing active COVID-19 disease in asymptomatic cases and in symptomatic patients without the typical radiologic findings. For the present COVID-19 outbreak in Italy, we describe 4 symptomatic patients with negative RT-PCR results at the first nasopharyngeal swab, which became positive when collected a few hours later by an otolaryngologist. All the patients showed nasal obstruction. The present report suggests that inadequate nasopharyngeal sampling performed by untrained operators in the presence of nasal obstruction can be a relevant case of false-negative findings at RT-PCR, with a clear negative impact on the efforts to contain the current outbreak.

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Olfactory and Gustatory Dysfunctions as a Clinical Manifestation of Coronavirus Disease 2019 in a Malaysian Tertiary Center

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420963165 ◽

2020 ◽

pp. 000348942096316 ◽

Cited By ~ 1

Author(s):

Kuganathan Ramasamy ◽

Jeyasakthy Saniasiaya ◽

Norhaslinda Abdul Gani

Keyword(s):

Nasal Obstruction ◽

Telephone Interview ◽

Complete Recovery ◽

Sudden Onset ◽

Olfactory Dysfunction ◽

Rt Pcr ◽

Younger Age ◽

Tertiary Center ◽

The Mean ◽

Polymerase Chain

Objective: To investigate the prevalence of olfactory and gustatory dysfunction among patients with COVID-19 infection and the recovery rate. Methods: Adult patients (≥18 years) tested positive for COVID-19 via reverse transcription-polymerase chain reaction (RT-PCR) and admitted in Hospital Tuanku Ja’afar Seremban, Malaysia, were recruited in this study. Patients completed a questionnaire via telephone interview comprising the following details: age, sex, ethnicity, comorbidities, general and otorhinolaryngological symptoms, onset and duration of olfactory and gustatory dysfunction. Patients with persistent olfactory and gustatory dysfunction at the time of the initial interview were followed-up every 3 to 5 days till resolution. Results: A total of 145 patients were included in our study. The mean age of patients was 43.0 ± 17.7 (range: 18-86). Fever (44.1%) and cough (39.3%) were the most prevalent general symptoms. Thirty-one patients (21.4%) reported olfactory dysfunction and 34 (23.4%) reported dysgeusia. There was a significant association between both olfactory and gustatory dysfunction ( P < .001). Altered sense of smell or taste occurred before other symptoms in 7 (15.9%); concomitant in 16 (36.4%) and after in 15 (34.1%). Six patients (13.6%) reported isolated sudden-onset anosmia. The median duration of olfactory and gustatory dysfunctions was 7 days. Complete recovery was achieved for 70.5% of the patients within 7 days of symptom onset. Only 6 (19.4%) of the 31 patients with olfactory dysfunction experienced nasal obstruction or rhinorrhea. Olfactory dysfunction was not significantly associated with nasal obstruction or rhinorrhea. Olfactory dysfunction was significantly associated with younger age ( P = .002), female ( P = .011), and hyperlipidemia ( P = .012). Gustatory dysfunction was significantly associated with fever ( P = .019) and cough ( P = .039). Conclusion: Olfactory and gustatory dysfunction is a pertinent manifestation of COVID-19. Most of the affected patients achieve rapid and complete recovery. Sudden onset of olfactory and gustatory dysfunction should be recognized as a major symptom of COVID-19 as we implore to contain this pandemic.

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Prognostic Value of Circulating Melanoma Cells Detected by Reverse Transcriptase–Polymerase Chain Reaction

Journal of Clinical Oncology ◽

10.1200/jco.2003.01.128 ◽

2003 ◽

Vol 21 (5) ◽

pp. 767-773 ◽

Cited By ~ 65

Author(s):

Giuseppe Palmieri ◽

Paolo A. Ascierto ◽

Francesco Perrone ◽

Sabrina M.R. Satriano ◽

Alessandro Ottaiano ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Subgroup Analysis ◽

Peripheral Blood ◽

Predictive Value ◽

Prognostic Value ◽

Rt Pcr ◽

Chain Reaction ◽

Blood Samples ◽

Stage Of Disease ◽

Polymerase Chain

Purpose: Factors that are predictive of prognosis in patients who are diagnosed with malignant melanoma (MM) are widely awaited. Detection of circulating melanoma cells (CMCs) by reverse transcriptase-polymerase chain reaction (RT-PCR) has recently been postulated as a possible negative prognostic factor. Two main questions were addressed: first, whether the presence of CMCs, defined as the patient being positive for any of the three markers, had a prognostic role; and second, what the predictive value of each individual marker was. Patients and Methods: A consecutive series of 200 melanoma patients observed between January 1997 and December 1997, with stage of disease ranging from I to IV, was analyzed by semiquantitative RT-PCR. Tyrosinase, p97, and MelanA/MART1 were used as markers to CMCs on baseline peripheral blood samples. Progression-free survival (PFS) was used as a unique end point and was described by the product limit method. Multivariable analysis was applied to verify whether the auspicated prognostic value of these markers was independent of the stage of disease, and a subgroup analysis was performed that excluded patients with stage IV disease. Results: Overall, 32% (64 of 200) of patients progressed, and a median PFS of 52 months in the whole series was observed. The presence of CMCs and the markers individually or combined was predictive of prognosis in the univariate analysis but did not provide additional prognostic information to the stage of disease in multivariable models. In the subgroup analysis of stage (ie, I–III subgroup), similar results were observed. Conclusion: Detection of CMCs in peripheral blood samples at the time of MM diagnosis by semiquantitative RT-PCR does not add any significant predictive value to the stage of disease. Thus, this approach should not be used in clinical practice, and further studies are required to determine its usefulness.

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The utility of real-time polymerase chain reaction in detecting Coccidioides immitis among clinical specimens in the Central California San Joaquin Valley

Medical Mycology ◽

10.1093/mmy/myy111 ◽

2018 ◽

Vol 57 (6) ◽

pp. 688-693 ◽

Cited By ~ 3

Author(s):

Dominic Dizon ◽

Marilyn Mitchell ◽

Bernadette Dizon ◽

Robert Libke ◽

Michael W Peterson

Keyword(s):

Polymerase Chain Reaction ◽

Real Time ◽

Pleural Fluid ◽

Clinical Setting ◽

Predictive Value ◽

Coccidioides Immitis ◽

Rt Pcr ◽

Chain Reaction ◽

Acute Pneumonia ◽

Polymerase Chain

AbstractCoccidioidomycosis, the fungal infection caused by dimorphic Coccidioides species, is typically diagnosed by histopathologic identification of spherules, by culture, or by serology. These tests are reliable but time-intensive, delaying diagnosis and treatment. Rapid real-time polymerase chain reaction (RT-PCR) can be performed and was validated to identify Coccidioides immitis using an in-house developed assay for the Becton Dickinson molecular instrument (BD MAXTM). These studies were performed using patient samples that had been shown to be positive on previously set up fungal cultures. To evaluate this new RT-PCR test in the clinical setting, we conducted a retrospective chart review of patients (N = 1160) who underwent Coccidioides PCR (Cocci PCR) on clinical samples between March 1, 2014, and Dec 31, 2016. We abstracted clinical, microbiologic, serologic, radiographic, treatment, and follow-up data. Specimens of cerebrospinal fluid (CSF), bronchioalveolar lavage fluid (BAL), lung tissue biopsy (LTB), sputum, and pleural fluid were evaluated to determine sensitivity and specificity. Of the 113 specimens that tested positive for Cocci PCR, all had clinical disease defined by traditional clinical criteria, yielding 100% specificity. Overall sensitivity was 74% versus 46% for fungal culture and was available in 4 hours rather than 1–2 weeks. Sensitivities varied by source material and clinical setting. CSF had a sensitivity of 59%, BAL for acute pneumonia 91%, sputum for acute pneumonia 94%, pleural fluid 86%, but LTB for lung nodules only 44%. Overall positive predictive value (PPV) was 100%, while negative predictive value (NPV) was 96%, but again this varied by specimen and clinical setting. Our experience with clinical testing of >1160 specimens over 2–3 years shows we can utilize this technology to improve our ability to diagnose disease but that the sensitivity varies by specimen source and clinical setting.

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Effectivity Analysis of SARS-CoV-2 Nasopharyngeal Swab Rapid Testing Kits in Pakistan: A Scenario of Inadequate COVID-19 Diagnosis

10.21203/rs.3.rs-315851/v1 ◽

2021 ◽

Cited By ~ 1

Author(s):

Umar Saeed ◽

Sara Rizwan Uppal ◽

Zahra Zahid Piracha ◽

Aftab Ahmad Khan ◽

Azhar Rasheed ◽

...

Keyword(s):

Gold Standard ◽

Rapid Detection ◽

International Health ◽

Time Frame ◽

Cross Sectional Study ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Cross Sectional ◽

International Health Organizations ◽

Polymerase Chain

Abstract COVID-19 pandemic has urged the need of rapid detection of SARS-CoV-2 in limited time frame. To cope with current, COVID-19 expanding scenario, accurate diagnosis of SARS-CoV-2 should be ensured by both national and international health organizations. Sporadic marketing of SARS-CoV-2 rapid detection kits raises questions regarding quality control and assurance. To aim of this study was to examine the effectiveness of SARS-CoV-2 nasopharyngeal swab based rapid detection kits, in comparison to gold standard USFDA approved triple target real-time polymerase chain reaction. A cross-sectional study of 1500 suspected COVID-19 patients was conducted. 100 RT-PCR confirmed patients nasopharyngeal swabs were evaluated for RDT. The COVID-19/SARS-CoV-2 NSP based RDT analysis showed 78% reactivity. Among RT-PCR confirmed negative subjects, 49.3% showed false positivity. The positive predictive analysis revealed 67.82% values, while the negative predictive vales of were 64.40%. The NSP RDTs showed limited sensitivities and specificities compared to gold standard RT-PCR. Accurate surveillance of COVID-19 is dependent upon authentic and validated SARS-CoV-2 detection nation-wide, which needs to be monitored by higher authorities. This study is critical for designing adequate measures by several COVID-19 strategic organizations to prevent future viral epidemics.

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SARS-CoV-2 show no infectivity at later stages in a prolonged COVID-19 patient despite positivity in RNA testing

10.1101/2021.03.18.21253228 ◽

2021 ◽

Author(s):

Xiu-Feng Wan ◽

Cynthia Y Tang ◽

Detlef Ritter ◽

Yang Wang ◽

Tao Li ◽

...

Keyword(s):

Large Scale ◽

Disease Onset ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Virus Growth ◽

Chain Reactions ◽

Polymerase Chain Reactions ◽

Asymptomatic Patients ◽

Hospitalization Period ◽

Polymerase Chain

Inpatient COVID-19 cases present enormous costs to patients and health systems. Many hospitalized patients may still test COVID-19 positive, even after resolution of symptoms. Thus, a pressing concern for clinicians is the safety of discharging these asymptomatic patients if they have any remaining infectivity. This case report explores the viral viability in a patient with persistent COVID-19 over the course of a two-month hospitalization. Positive nasopharyngeal swab samples, analyzed by quantitative reverse transcription polymerase chain reactions (qRT-PCR), were collected and isolated in the laboratory, and infectious doses were analyzed throughout the hospitalization period. The patient experienced waning symptoms by hospital day 40 and had no viable virus growth in the laboratory by hospital day 41, suggesting no risk of infectivity, despite positive RT-PCR results, which prolonged his hospital stay. Notably, this case showed infectivity for at least 24 days from disease onset, which is longer than the discontinuation of transmission-based precautions recommendation by CDC. Thus, our findings suggest that the timeline for discontinuing transmission-based precautions may need to be extended for patients with prolonged illness. Additional large-scale studies are needed to draw definitive conclusions on the appropriate clinical management for these patients.

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Detection of SARS-CoV-2 by real time Reverse Transcriptase-Polymerase Chain Reaction assay in pleural effusion

International Journal of Case Reports ◽

10.28933/ijcr-2021-02-1605 ◽

2021 ◽

pp. 201

Author(s):

Keyword(s):

Polymerase Chain Reaction ◽

Pleural Effusion ◽

Reverse Transcriptase ◽

Pleural Fluid ◽

Interstitial Pneumonia ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Pleural Involvement

SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) is a novel coronavirus identified for the first time in Wuhan (China) in 2019, responsible of the current pandemic infection known as Coronavirus-19 disease (COVID-19). Wide range of clinical presentation of COVD -19 has been observed, from asymptomatic carriers to ARDS. The common signs and symptoms of SARS-CoV-2 infection include fever, fatigue, dry cough, and dyspnoea; the severity of the disease is due to the impairment of the respiratory function. The radiological findings include a large variety of lesions; bilateral interstitial pneumonia is the most concerning presentation of COVID-19. Pleural involvement has been described in a minority of cases: pleural thickening had been observed in 32% of cases whereas pleural effusion is uncommon being described in only 5%. Furthermore, pleural involvement has been significantly associated with a worse prognosis. Coronavirus 2 (SARS-CoV-2), beyond the nasopharyngeal swab, has been detected in other samples; up to now, data about RT-PCR specific results in the pleural fluid of patients suffering from coronavirus disease 2019 5 (COVID-19) are very limited. The current gold standard for diagnosis is nucleic acid detection by real time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in nasopharyngeal swab. In this report, a case of a positive RT-PCR for Sars-Cov-2 in the pleura fluid and in the naso- pharyngeal swab of a patient affected by bilateral interstitial pneumonia and severe respiratory failure is described. As the presence of SARS-Cov-2 in the pleural fluid seems to be associated to a poor prognosis, physicians should carry out the specific RT-PCR assay both in the nasopharyngeal swab and in the pleural sample also when the fluid amount is very scarce and not recognizable in the chest X ray. Furthermore, the analysis of multiple samples allows to increase the test reliability.

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Is the Portable Chest Radiographic More Reliable to Reveal Covid19 in Highly Suspicion Patient before Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR) Test?

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i03/1085 ◽

2021 ◽

Vol 6 (03) ◽

pp. 228-236

Author(s):

Bushra A. A. Albazi ◽

Dr Noof. Albaz ◽

Dr Nayef. Alqahtani ◽

Dr. Angham Salih ◽

Dr Rafat Mohtasab

Keyword(s):

Polymerase Chain Reaction ◽

Retrospective Study ◽

Predictive Value ◽

Rt Pcr ◽

Chain Reaction ◽

X Ray ◽

Polymerase Chain ◽

Rate Type ◽

Test Result ◽

Pcr Test

A large number of patients with coronavirus disease 2019 (COVID-19) present at hospitals. There are a limited number of isolation rooms open, and patients must often wait a long time to get a reverse transcription-polymerase chain reaction (RT-PCR) test done. This necessitates the introduction of effective triage plans. A patient with suspicions is referred to an emergency room (ED) depending on their medical record for a simple physical assessment, blood test findings, and chest imaging.A retrospective study design was conduct at Prince Sultan Medical Military City (PSMMC). Ethical approval was obtained from the institutional board to wave the consent forms since it is a retrospective study. Only the primary investigator has had the data access to the patients’ medical records. The collected patient records were under specific categories, including symptoms score starts from 5 and above, RT-PCR test result done after CXRP imaging, the patient admitted to the emergency department (ED). Excluding all CXRP done after RT-PCR TEST, positive Covid 19 admitted to the intensive care unit (ICU), pediatric patients, and patients with score symptoms were less than five. Two experienced radiologists reviewed the images blindly, and the inter-observer reliability of observations noted by the radiologists was calculated. As for the relationship between the x-ray reading and the RT-PCR test result, our results showed a high correlation between the variables (chi-square χ² = 12.44, with df =1, and p<0.001). The sensitivity of x-ray diagnosing covid19 was 65.52 %, while the specificity was 54.51 %, and the accuracy of radiologists reading was 58.17 %. Furthermore, the positive predictive value (PPV) was 41.76 %, and the negative predictive value (NPV) was 76.05%. Finally, the false positive rate (type-i error (alpha) was 45.49%, and the false-negative rate (type-ii error (beta) was 34.48% Our research findings show that CXRP imaging can detect COVID-19 infection in symptomatic patients and can be a valuable addition to RT-PCR testing. In an inpatient ED environment where availability of test kits, laboratory equipment, and laboratory personnel is compromised and risks delaying patient treatment and hospital workflow, serial CXRP could theoretically be used as an adjunct diagnostic function and monitoring in patients suspected of having COVID-19.

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Performance comparison of two malaria rapid diagnostic test with real time polymerase chain reaction and gold standard of microscopy detection method

Infectious Disease Reports ◽

10.4081/idr.2020.8731 ◽

2020 ◽

Author(s):

Puspa Wardhani ◽

Trieva Verawaty Butarbutar ◽

Christophorus Oetama Adiatmaja ◽

Amarensi Milka Betaubun ◽

Nur Hamidah ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Real Time ◽

Diagnostic Test ◽

Real Time Pcr ◽

Predictive Value ◽

Gold Standard ◽

Detection Method ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain

Background: The diagnostic test for malaria is mostly based on Rapid Diagnostic Test (RDT) and detection by microscopy. Polymerase Chain Reaction (PCR) is also a sensitive detection method that can be considered as a diagnostic tool. The outcome of malaria microscopy detection depends on the examiner's ability and experience. Some RDT has been distributed in Indonesia, which needs to be evaluated for their results. Objective: This study aimed to compare the performance of RightSign RDT and ScreenPlus RDT for detection of Plasmodium in human blood. We used specific real-time polymerase chain reaction abTESTMMalaria qPCRII) and gold standard of microscopy detection method to measure diagnostic efficiency. Methods: Blood specimens were evaluated using RightSign RDT, ScreenPlus RDT, Microscopy detection, and RT-PCR as the protocol described. The differences on specificity (Sp), sensitivity (Sn), positive predictive value (PPV), and negative predictive value (NPV) were analyzed using McNemar and Kruskal Wallis analysis. Results: A total of 105 subjects were recruited. Based on microscopy test, RightSign RDT had sensitivity, Specificity, PPV, NPV, 100%, 98%, 98.2%, 100%, respectively. ScreenPlus showed 100% sensitivity, 98% specificity, 98.2% PPV, 100% NPV. The sensitivity of both RDTs became lower (75%) and the specificity higher (100 %) when using real-time PCR. Both RDTs showed a 100% agreement. RT-PCR detected higher mix infection when compared to microscopy and RDTs. Conclusion: RightSign and ScreenPlus RDT have excellent performance when using microscopy detection as a gold standard. Real-time PCR method can be considered as a confirmation tool for malaria diagnosis.

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