Materiały źródłowe

• #1 Malaria Diagnosis: A Brief Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2688806/

  Malaria is a major cause of death in tropical and sub-tropical countries, killing each year over 1 million people globally; 90% of fatalities occur in African children. […] In this emergency situation, prompt and effective diagnostic methods are essential for the management and control of malaria. Traditional methods for diagnosing malaria remain problematic; therefore, new technologies have been developed and introduced to overcome the limitations. This review details the currently available diagnostic methods for malaria. […] The need for effective and practical diagnostics for global malaria control is increasing, since effective diagnosis reduces both complications and mortality from malaria. […] Therefore, confirmatory diagnoses using laboratory technologies are urgently needed. This review discusses on the currently available diagnostic methods for malaria in many settings, and assesses their feasibility in resource-rich and resource-poor settings.

• #1 Diagnostic testing

  https://www.who.int/teams/global-malaria-programme/case-management/diagnosis

  Prompt malaria diagnosis either by microscopy or rapid diagnostic tests (RDTs) is recommended by WHO for all patients with suspected malaria before they are given treatment. […] Early and accurate diagnosis is essential both for effective management of the disease and for strong malaria surveillance. […] Parasite-based diagnostic testing significantly reduces illness and death by enabling health providers to swiftly distinguish between malarial and non-malarial fevers and select the most appropriate treatment. […] Where quality-assured diagnosis is readily available, health-care providers should only give antimalarial treatment to patients who test positive, while those who test negative should be assessed for other causes of fever. […] Since 2010, when WHO recommended testing of all suspected malaria cases, the proportion of patients receiving a malaria diagnostic test has increased significantly.

• #1

  https://www.who.int/activities/diagnostic-testing-for-malaria

  WHO recommends prompt malaria diagnosis either by microscopy or rapid diagnostic tests (RDTs) for all patients with suspected malaria before they are given treatment. […] Early and accurate diagnosis is essential both for effective management of malaria and other febrile illnesses and for strong malaria surveillance. […] To promote quality assurance of malaria microscopy, WHO coordinates the external competence assessment of malaria microscopists (ECAMM), involving participants from 63 malaria endemic countries in the WHO Western Pacific, South-East Asia, African and Eastern Mediterranean regions. […] In 2008, WHO and the Foundation for Innovative New Diagnostics (FIND) established an international quality assurance scheme in collaboration with the US Centers for Disease Prevention and Control to generate recommended criteria for selecting malaria RDTs.

• #1 CDC – Malaria – Diagnosis & Treatment (United States) – Diagnosis (U.S.)

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/malaria/diagnosis_treatment/diagnosis.html

  Malaria must be recognized promptly in order to treat the patient in time and to prevent further spread of infection in the community via local mosquitoes. […] Malaria should be considered a potential medical emergency and should be treated accordingly. Delay in diagnosis and treatment is a leading cause of death in malaria patients in the United States. […] Malaria can be suspected based on the patient’s travel history, symptoms, and the physical findings at examination. However, for a definitive diagnosis to be made, laboratory tests must demonstrate the malaria parasites or their components. […] Diagnosis of malaria can be difficult: […] If possible, clinical findings should always be confirmed by a laboratory test for malaria. […] Malaria parasites can be identified by examining under the microscope a drop of the patient’s blood, spread out as a „blood smear” on a microscope slide.

• #1 Malaria Diagnosis: A Brief Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2688806/

  Prompt and accurate diagnosis is critical to the effective management of malaria. […] Malaria diagnosis involves identifying malaria parasites or antigens/products in patient blood. […] Diagnosis can be difficult where malaria is no longer endemic for healthcare providers unfamiliar with the disease. […] In many malaria-endemic countries, the lack of resources is a major barrier to reliable and timely diagnosis. […] A clinical diagnosis of malaria is traditional among medical doctors. […] The overlapping of malaria symptoms with other tropical diseases impairs diagnostic specificity, which can promote the indiscriminate use of antimalarials and compromise the quality of care for patients with non-malarial fevers in endemic areas. […] The accuracy of malaria diagnosis can be greatly enhanced by combining clinical-and parasite-based findings.

• #1 Malaria Diagnostic Tests | Malaria | CDC

  https://www.cdc.gov/malaria/hcp/diagnosis-testing/malaria-diagnostic-tests.html

  Microscopic examination of blood films is the gold standard for laboratory confirmation of malaria parasites. […] A Rapid Diagnostic Test (RDT) is an alternate way of quickly establishing the diagnosis of malaria. […] PCR can help identify the Plasmodium species to ensure proper treatment. […] Microscopic examination remains the „gold standard” for laboratory confirmation of malaria. […] It is vital that health-care providers receive results from these tests within hours in order to appropriately treat their patients infected with malaria. […] Malaria microscopy is a well-established method requiring minimal, widely available equipment, supplies, and reagents. […] Once the diagnosis is established usually by detecting parasites in the thick smear the microscopist can examine the thin smear to determine the malaria species and the parasitemia, or the percentage of the patient’s red blood cells that are infected with malaria parasites.

• #1 Accuracy of diagnosis among clinical malaria patients: comparing microscopy, RDT and a highly sensitive quantitative PCR looking at the implications for submicroscopic infections | Malaria Journal | Full Text

  https://malariajournal.biomedcentral.com/articles/10.1186/s12936-023-04506-5

  The World Health Organization recommends parasitological confirmation of all suspected malaria cases by microscopy or rapid diagnostic tests (RDTs) before treatment. […] This study, therefore, sought to investigate the clinical performance of microscopy and RDT assuming highly sensitive varATS qPCR as gold standard. […] Parasite prevalence was 17.5%, 24.5%, and 42.1% by microscopy, RDT, and varATS qPCR respectively. […] Consequently, RDT recorded better diagnostic agreement (kappa=0.571) with varATS qPCR than microscopy (kappa=0.409) for clinical detection of malaria. […] RDT outperformed microscopy for the diagnosis of Plasmodium falciparum malaria in the study. […] However, both tests missed over 40% of infections that were detected by varATS qPCR. […] The accuracy of microscopy is variable and largely dependent on the expertise of the microscopist and the quality of staining reagents.

• #1 Diagnosis of malaria – Wikipedia

  https://en.wikipedia.org/wiki/Diagnosis_of_malaria

  The mainstay of malaria diagnosis has been the microscopic examination of blood, utilizing blood films. […] Although blood is the sample most frequently used to make a diagnosis, both saliva and urine have been investigated as alternative, less invasive specimens. […] More recently, modern techniques utilizing antigen tests or polymerase chain reaction have been discovered, though these are not widely implemented in malaria endemic regions. […] The most economic, preferred, and reliable diagnosis of malaria is microscopic examination of blood films because each of the four major parasite species has distinguishing characteristics. […] Two sorts of blood film are traditionally used. […] With the pros and cons of both thick and thin smears taken into consideration, it is imperative to utilize both smears while attempting to make a definitive diagnosis.

• #1 Diagnosis of malaria – Wikipedia

  https://en.wikipedia.org/wiki/Diagnosis_of_malaria

  From the thick film, an experienced microscopist can detect parasite levels (or parasitemia) as few as 5 parasites/L blood. […] Diagnosis of species can be difficult because the early trophozoites („ring form”) of all four species look similar and it is never possible to diagnose species on the basis of a single ring form; species identification is always based on several trophozoites. […] As malaria becomes less prevalent due to interventions such as bed nets, the importance of accurate diagnosis increases. […] Therefore, modern methods such as PCR (see „Molecular methods” below) or monoclonal antibody panels that can distinguish between the two should be used in this part of the world. […] For areas where microscopy is not available, or where laboratory staff are not experienced at malaria diagnosis, there are commercial antigen detection tests that require only a drop of blood.

• #1 The Laboratory Diagnosis of Malaria: A Focus on the Diagnostic Assays in Non-Endemic Areas

  https://www.mdpi.com/1422-0067/25/2/695

  Malaria diagnoses should be confirmed by laboratory assays and patients should be promptly directed to a facility with diagnostic capabilities. […] Microscopy is still considered the gold standard for malaria diagnosis, despite advances in diagnostic technologies in the past 20 years. […] In all clinical settings according to the WHO, a malaria diagnosis must be performed by microscopic examination of Giemsa-stained thin and thick blood smears for Plasmodium sp. identification and parasitemia count or rapid diagnostic tests (RDTs). […] The advantages of light microscopy include (a) low direct costs in a high-volume sample; (b) good sensitivity and results in 2 h; (c) identification of Plasmodium sp. and stage differentiation; (d) parasitemia count; (e) drug-induced morphological changes observation; (f) the absence of parasites to assess the clearance of the plasmodia; (g) screening for other related blood abnormalities and other blood parasites at once.

• #1 Update on Malaria Diagnostics and Test Utilization

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5483902/

  It is important to note that examination of a single set of blood films may be insufficient for malaria diagnosis, particularly with low levels of parasitemia. The Clinical and Laboratory Standards Institute (CLSI) recommends that repeat blood films be obtained and examined every 6 to 8 h for up to 3 days (if clinically indicated) until malaria is definitively excluded from the differential diagnosis. […] The thick film should be examined first for parasites, and the thin film used to identify organisms to the species level. Both the thick and thin films should be examined at 100 magnification with oil immersion for a minimum of 100 fields, and up to at least 300 fields for immunologically naive patients (i.e., those without previous Plasmodium exposure), as they may present with symptoms at a lower level of parasitemia.

• #1 Update on Malaria Diagnostics and Test Utilization

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5483902/

  The quantification of malaria parasites can be used to make clinical management decisions as well as for monitoring response to treatment. Quantification can be performed using the thick or thin film. […] Several antigen rapid detection tests (RDTs) are commercially available and are increasingly used for malaria diagnosis worldwide. […] The WHO, in conjunction with the CDC, the Foundation for Innovative New Diagnostics, and the Special Programme for Research and Training in Tropical Diseases, completed extensive comparisons of commercially available RDTs in 6 separate rounds and found significant disparities in performance characteristics among available methods. […] Given the significantly lower sensitivities for non-falciparum species and for detection of low levels of parasitemia (all species), the BinaxNOW Malaria test should be used for malaria diagnosis only in conjunction with other laboratory tests (e.g., blood film examination) and the clinical findings.

• #1 The Laboratory Diagnosis of Malaria: A Focus on the Diagnostic Assays in Non-Endemic Areas

  https://www.mdpi.com/1422-0067/25/2/695

  Parasitemia is essential for the classification of malaria severity and prognosis: a parasite density of more than 5% is a criterion to identify severe malaria cases and parasite density counting should be continued until parasites are cleared as a follow-up to evaluate the response to the anti-malaria treatment. […] Unfortunately, microscopy has several limitations: (a) it cannot differentiate the morphology of all the stages between P. knowlesi and P. malariae; (b) it cannot differentiate the morphology of the early ring trophozoites between P. knowlesi and P. falciparum; (c) many parasites can be missed during the staining procedure bringing to both a reduced sensitivity of the method and an incorrect count of the parasite density; (d) it has a limited analytic sensitivity causing a microscopic threshold of 50 parasites/μL and does not diagnose mixed infections; (e) it requires the availability of experienced laboratory personnel, particularly microscopists.

• #1 Malaria Diagnostic Tests | Malaria | CDC

  https://www.cdc.gov/malaria/hcp/diagnosis-testing/malaria-diagnostic-tests.html

  A Rapid Diagnostic Test (RDT) is an alternate way of quickly establishing the diagnosis of malaria infection by detecting specific malaria antigens in a person’s blood. […] High-quality malaria microscopy is not always immediately available in every clinical setting where patients might seek medical attention. […] The use of the RDT does not eliminate the need for malaria microscopy. […] PCR results are often not available quickly enough to be of value in establishing the diagnosis of malaria infection. […] PCR is most useful for confirming the species of malarial parasite after the diagnosis has been established by either smear microscopy or RDT.

• #1 NOUL Blog | 3 Comprehensive Malaria Diagnostic Solutions: Microscopic Examination, RDTs, and PCR for Accurate Detection

  https://noul.com/en/board_news_blog/3-key-solutions-for-malaria-diagnosis/

  RDTs use monoclonal antibodies to detect specific malaria antigens in a blood sample. The results appear as visible lines on the dipstick or cassette (similar to a pregnancy test) within 15-20 minutes. […] Molecular diagnosis that uses PCR is a highly sensitive method that detects malaria parasite DNA with exceptional specificity. […] Polymerase chain reaction (PCR) amplifies parasite DNA from a blood sample. This method precisely identifies malaria species and detects drug-resistant strains. […] miLab MAL is the new player in town. It addresses the limitations of traditional diagnostic tools through the integration of advanced technology into a single device. […] The introduction of miLab MAL has the potential to transform malaria diagnostics around the world. Today, the challenges of resource variability are very important to address. In regions with high malaria burdens (e.g., sub-Saharan Africa, Southeast Asia), miLab MAL can significantly reduce diagnostic delays and improve disease management outcomes.

• #1 Diagnosis of malaria – Wikipedia

  https://en.wikipedia.org/wiki/Diagnosis_of_malaria

  The threshold of detection by these rapid diagnostic tests is in the range of 100 parasites/L of blood compared to 5 by thick film microscopy. […] One disadvantage is that dipstick tests are qualitative but not quantitative they can determine if parasites are present in the blood, but not how many. […] Modern rapid diagnostic tests for malaria often include a combination of two antigens such as a P. falciparum specific antigen e.g. histidine-rich protein II (HRP II) and either a P. vivax specific antigen e.g. P. vivax LDH or an antigen sensitive to all plasmodium species which affect humans e.g. pLDH. […] PCR (and other molecular methods) is more accurate than microscopy. […] However, it is expensive, and requires a specialized laboratory. […] Therefore, more sensitive, low-tech diagnosis tools need to be developed in order to detect low levels of parasitemia in the field.

• #1 Malaria rapid diagnostic tests (RDTs) | PVIVAX

  https://www.vivaxmalaria.org/diagnosis-treatment/plasmodium-vivax-diagnosis/malaria-rapid-diagnostic-tests-rdts

  Malaria rapid diagnostic tests (RDTs) assist in the diagnosis of malaria by detecting evidence of malaria parasites (antigens) in human blood. These tests require a drop of peripheral blood, normally collected from a finger or heel prick. Visual read-outs are available typically within 20 mins or less. […] RDTs for P. vivax have relatively poor performance compared with those for P. falciparum, and uptake has been slow and inconsistent. This is due to a combination of lower parasite density in P. vivax infections, lower expression of the specific antigen being detected for this species, and poorer performance of the reagents used for this specific antigen. As a consequence, many RDTs might fail to detect P. vivax in samples containing 200 parasites/L. […] P. vivax malaria diagnosis and treatment are critical to ensure that malaria elimination efforts are reached. […] Molecular methods and serology are key tools for the detection of P. vivax parasites.

• #1 Malaria 101 – 'D’ is for DIAGNOSIS and rapid treatment: The faster, the better | University of Pretoria

  https://www.up.ac.za/faculty-of-health-sciences/news/post_3194869-malaria-101-d-is-for-diagnosis-and-rapid-treatment-the-faster-the-better

  Microscopic examination of blood smears is a standard and widely used method for diagnosing malaria. With a blood smear, a drop of an individuals blood is examined under a light microscope for the presence of parasites between and in the red blood cells. Thick smears are primarily used for detecting parasites and estimating parasite density, while thin smears allow for species identification. […] RDTs detect specific malaria antigens in the blood. They are easy to use and provide results within 15 to 20 minutes. RDTs are particularly useful in areas where microscopy is not readily available. Different types of RDTs are available, including those that detect specific Plasmodium species or general malaria antigens. […] PCR tests are molecular diagnostic tools that can detect the genetic material of the malaria parasite. PCR is highly sensitive and can identify low levels of parasites in the blood. While more sophisticated and not as readily available in some settings, PCR is useful for confirming malaria diagnosis, especially in cases where microscopy or RDT results are inconclusive.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Malaria-Diagnosis.aspx

  Rapid diagnostic tests (RDTs) are also employed for easy detection and take around 2 to 15 minutes. These tests detect parasite antigens. These can be used by relatively untrained staff. […] Polymerase chain reaction (PCR) is a more sophisticated method of diagnosing malaria. It is expensive and less available in endemic zones. Parasite nucleic acids are detected using PCR. PCR is most useful for confirming the species of the malarial parasite after the diagnosis has been established by either smear microscopy or RDT. […] Serology may also be used to detect antibodies against malaria parasites. This can be done using either indirect immunofluorescence (IFA) or enzyme-linked immunosorbent assay (ELISA). Serology does not detect current infection but rather measures past exposure. […] Apart from the detection of the parasite, other tests are also ordered. These include complete blood counts that reveal anemia, low platelet counts, and rarely high white blood cell counts.

• #1 Advances in Malaria Diagnostic Methods in Resource-Limited Settings: A Systematic Review

  https://www.mdpi.com/2414-6366/9/9/190

  Rapid diagnostic tests (RDTs) are fast and reliable. Malaria RDTs do not require skilled personnel or constant electricity, but relative to malaria microscopy, they are expensive, have a short shelf life, and only give qualitative results. […] This systematic review looks at traditional and modern techniques in light of their main advantages and disadvantages, as well as the countries where they have been used, with emphasis placed on lower and lower-middle-income countries. […] The findings from this review suggest great advancement recently in malaria diagnostics. Research efforts by many scientists around the globe have progressed from developing improved malaria microscopy techniques into enhanced and more accurate molecular, immunological, computerized, digital methods of detection, automated analyzers, and point-of-care devices.

• #1 Accuracy of diagnosis among clinical malaria patients: comparing microscopy, RDT and a highly sensitive quantitative PCR looking at the implications for submicroscopic infections | Malaria Journal | Full Text

  https://malariajournal.biomedcentral.com/articles/10.1186/s12936-023-04506-5

  The advent of rapid diagnostic tests and its adoption in Ghana has led to a significant reduction in presumptive diagnosis across the country. […] Nevertheless, RDTs are only qualitative and reportedly yield more false positives (than microscopy) due to persistent circulation of antigens (HRP-2) even after parasite clearance by anti-malarials. […] Studies have shown most RDTs to be less sensitive at low parasite densities (200 parasites/L), thus missing chronic latent infections in asymptomatic populations, particularly in low-transmission settings. […] Nucleic acid amplification tests (NAATs) provide by far the highest sensitivity and specificity for malaria diagnosis. […] The limit of detection of varATS qPCR has been reported as 0.03 parasites/l of blood. […] This study provides baseline information on how the commonly used malaria tests in Ghana perform against varATS qPCR.

• #1 Severe Malaria Diagnosis | Severe Malaria Observatory

  https://www.severemalaria.org/severe-malaria/severe-malaria-diagnosis

  Obtaining a parasitological diagnosis does not resolve the diagnostic problem, especially in high transmission areas, where asymptomatic parasitaemia is common and may be incidental in any severe illnesses. […] Malaria Rapid Diagnostic Tests (RDTs) are based on the detection of different antigens produced by the parasite. […] The tests are not quantitative, and the correlation between antigen concentration and parasitemia is not fully understood, so these do not provide information on the parasite density, which is an important parameter in monitoring a patient being treated for severe malaria. […] HRP2-detecting tests have shown instances of less sensitivity in parasites that express little or no target antigen, resulting in false negative results. […] Reports stemming from several countries in South America and Africa have confirmed the identification of P. falciparum parasites with PfHRP2/PfHRP3 gene deletions, not expressing PfHRP2 and/or PfHRP3.

• #1 Malaria Diagnosis: A Brief Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2688806/

  In the laboratory, malaria is diagnosed using different techniques, e.g. conventional microscopic diagnosis by staining thin and thick peripheral blood smears, other concentration techniques, rapid diagnostic tests, and molecular diagnostic methods, such as polymerase chain reaction (PCR). […] Conventional microscopic examination of peripheral thick and thin blood smears remains the gold standard for malaria diagnosis. […] Quick and convenient RDTs are currently implemented in many remote settings, but are costly and need improved quality control. […] Molecular-biological techniques are appropriate for research laboratories; they can be used to identify the development of drug-resistance, are useful for species identification, and also for quantifying parasite density with low parasitemia. […] Finally, the level of malaria endemicity, the urgency of diagnosis, the experience of the physician, the effectiveness of healthcare workers, and budget resources, are all factors influencing the choice of malaria-diagnostic method.

• #1 Point-of-Care Strategies Applied to Malaria Diagnosis | IntechOpen

  https://www.intechopen.com/chapters/75673

  Rapid diagnostic test (RDT) is a quick diagnostic approach to detect malaria among malaria-suspected patients and rule out malaria among individuals without malaria. […] PCR is more sensitive than both microscopy and immunochromatographic tests. PCR has been found to be especially useful for identifying low-level infections often missed by other techniques, showing a detection limit in the range of 0.55 parasites per L of sample. […] LAMP has also been coupled with a MiniION sequencer, being able to amplify a genomic target and then differentiate all five Plasmodium species. […] A complete technological solution able to extract DNA, amplify and detect specific DNA sequences from malaria parasites was published. […] An absolute requirement for identification and treatment of all parasite carriers, both symptomatic and asymptomatic, is inherent to all malaria elimination programs.

• #1 Advances in Malaria Diagnostic Methods in Resource-Limited Settings: A Systematic Review

  https://www.mdpi.com/2414-6366/9/9/190

  Studies confirm PCR-based techniques as having widespread use globally as they are highly sensitive and capable of detecting very low parasitemia levels. […] Our findings reveal that a wide range of PCR assays have been developed or used over the past decade, which are less laborious and provide much faster and more accurate results. […] LAMP-based assays have also dominated research on malaria diagnostics. […] Other molecular methods worthy of note as they double as point-of-care or easy-to-use methods include nuclear magnetic resonance (NMR)-based hemozoin detection, ultra-bright SERS nanorattles, recombinase-aided amplification with lateral flow dipstick assay, and dye-coupled aptamer-captured enzyme-catalyzed assay. […] Given the literature reviewed, there is adequate evidence to suggest that malaria detection or diagnosis will progress significantly in the next decade and beyond towards needleless detection. This advancement will however require increased, detailed, and specified research into the various molecular identifiers and phenotypic variant characteristics of malaria infection while enhancing the accuracy, precision, and specificity of the modernized point-of-care diagnostic tools.

• #1 SciELO Brazil – Malaria diagnosis from pooled blood samples: comparative analysis of real-time PCR, nested PCR and immunoassay as a platform for the molecular and serological diagnosis of malaria on a large-scale Malaria diagnosis from pooled blood sampl

  https://www.scielo.br/j/mioc/a/ztw6RYJmbQ3WRTypLcmsdQH/?lang=en

  The real-time PCR is a fast, automated, accurate and efficient technique for applications with large numbers of samples. […] This study served as a comparative analysis between molecular techniques (real-time PCR and nested PCR) and a rapid test for the detection of specific antibodies. […] The standard reference method for malaria diagnosis is the thick blood film, but the reduced sensitivity of this test at low parasitemias and the reduced ability of this test to detect mixed infections limit its use in epidemiological or clinical studies and in blood therapy services with large numbers of samples. […] This study presents the results of a screening platform for the molecular and serological diagnosis of malaria on a large scale. […] Based on these results, we support the use of real-time PCR for the genus-specific screening of samples followed by the use of nested PCR for the identification of the Plasmodium species avoiding the use of the nested PCR for negative samples.

• #1 CDC – Malaria – Diagnosis & Treatment (United States) – Diagnosis (U.S.)

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/malaria/diagnosis_treatment/diagnosis.html

  Various test kits are available to detect antigens derived from malaria parasites. […] On June 13, 2007, the U.S. Food and Drug Administration (FDA) approved the first RDT for use in the United States. […] PCR is most useful for confirming the species of malarial parasite after the diagnosis has been established by either smear microscopy or RDT. […] Serology detects antibodies against malaria parasites, using either indirect immunofluorescence (IFA) or enzyme-linked immunosorbent assay (ELISA). […] CDC recommends that all cases of malaria diagnosed in the United States should be evaluated for evidence of drug resistance.

• #1 Chapter 6 – Malaria diagnosis: Canadian recommendations for the prevention and treatment of malaria – Canada.ca

  https://www.canada.ca/en/public-health/services/catmat/canadian-recommendations-prevention-treatment-malaria/chapter-6-malaria-diagnosis.html

  The diagnosis of malaria is considered a medical emergency, and every clinical site where potential cases are assessed should have a system for ensuring rapid, reliable testing either on site or via rapid referral. […] Microscopy requires a high level of training and expertise, and remains the gold standard test. […] Rapid diagnostic tests, which are based on antigen detection, should always be promptly available. They have imperfect sensitivity, good specificity, but only moderately reliable speciation results. […] LAMP (a form of nucleic acid amplification test) is a rapid and simple test with high sensitivity and specificity; however it does not currently provide speciation. LAMP testing can be used to rule out malaria without further testing. The test is currently approved in Canada.

• #1 Point-of-Care Strategies Applied to Malaria Diagnosis | IntechOpen

  https://www.intechopen.com/chapters/75673

  Microscopy, for example, requires few and inexpensive equipments, can be operated under virtually any environment conditions and within a few hours of collecting the blood, the microscopy test can provide valuable information. However, microscopy requires a very skilled professional for appropriate reading of the slides, which poses a problem due to the relative scarce availability. […] RDTs, on the other hand, do not require a skilled professional and also does not require expensive instruments. […] PCR is very sensitive and specific, as well as a very robust and well understood technique. […] Compared to PCR, LAMP has the advantage of not requiring a complex and sensitive instrument, using less energy and time to achieve a sensitive target detection. […] Non-invasive methods such as infrared detection of hemozoin are very promising due to the good results in field tests and low cost of the instrument. […] Finally, yet importantly, microfluidic techniques should collaborate with any nucleic acid amplification technique to make feasible a robust, sensitive and specific malaria POC diagnostic assay.

• #1 Advancements and Challenges in Malaria Diagnostics | IntechOpen

  https://www.intechopen.com/online-first/1218680

  The LAMP technique is considered to be a more simplified and affordable technique. […] The laser desorption mass spectrometry-based diagnostic for malaria was developed two decades ago. […] Flow cytometry is a high-throughput technique to count and separate viable cells in a stream of fluid using a laser device that reveals the fluorescent markers on the cells. […] Convolutional neural networks (CNNs) are AI models that can help in analyzing microscopic images of thick and thin blood smear samples using deep learning tools. […] Malaria Screener is the first smartphone-based application that can detect Plasmodium falciparum infection from Giemsa-stained blood smears with an accuracy of 74% compared to the expert microscopy and 71% when compared with the nested PCR as a reference. […] The primary factor that drives the market is the elevating incidences of malaria, which leads to the increasing demand for effective malaria diagnostics. […] The precise and timely detection of malaria infection is indeed critical for effective management and treatment.

• #1 The Laboratory Diagnosis of Malaria: A Focus on the Diagnostic Assays in Non-Endemic Areas

  https://www.mdpi.com/1422-0067/25/2/695

  The main limitations of RDTs together with the risk of false positive and false negative results, include their inability to quantify the parasitemia, to distinguish among the parasitic stages and the potential missing of double infections. […] More often in recent years, laboratories have adopted molecular methods for the diagnosis of malaria over traditional methods. […] As expected, molecular methods have been demonstrated to be at least 10-fold more sensitive than microscopy, proving to be more effective in revealing additional cases of P. falciparum including mixed infections missed at microscopy and in differentiating correctly the five species of Plasmodium sp. of causing malaria in humans. […] Molecular assays are generally proposed as confirmatory methods and they are decisive in cases of submicroscopic parasitemia or when mixed infections are suspected and when the morphologic characteristics of the parasite stages overlap, and/or in cases of altered parasite morphology induced by a drug treatment or improper sample handling or storage.

• #1 Malaria (Plasmodium) – Serology | Public Health Ontario

  https://www.publichealthontario.ca/en/laboratory-services/test-information-index/malaria-serology

  Malaria serology is not the recommended testing method for diagnosis of acute malaria. […] Serology should not be used for routine diagnosis of acute malaria. Its role is primarily limited to individuals linked to a case of transfusion-transmitted, transplant-associated, or congenital malaria with negative microscopy and PCR results, or in instances of suspected hyperreactive malarial splenomegaly (HMS) syndrome with negative microscopy and PCR results. […] Serologic testing for malaria is not performed routinely, and must be pre-approved by the PHO microbiologist before submission. […] Malaria serology is not performed routinely and must be pre-approved by a PHO microbiologist before submission. […] Method: Malaria serology is performed by enzyme-linked immunosorbent assay (ELISA). It uses a mixture of recombinant antigens of all human pathogenic Plasmodium species.

• #1 Malaria (Plasmodium) – Serology | Public Health Ontario

  https://www.publichealthontario.ca/en/laboratory-services/test-information-index/malaria-serology

  Performance: The NRCP states a sensitivity of 96% and specificity of 99% in immunocompetent individuals. […] Limitations: Serology may be negative early in infection or in patients with impaired immunity. False positive reactions may occur in patients with autoimmune disorders (e.g., rheumatoid arthritis). Serology may remain positive for years following clearance of infection and does not distinguish acute from chronic, past, or recurrent infection. Cross-reactivity may occur with Leishmania spp infections. […] Malaria ELISA performed at the NRCP: 1.1 Positive Detectable level of antibodies against Plasmodium spp. Cannot distinguish between acute and remote infection. Cross-reactivity may occur with Leishmania spp.

• #1 Update on Malaria Diagnostics and Test Utilization

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5483902/

  Malaria is a potentially life-threatening disease requiring rapid diagnosis and treatment. Although microscopic examination of thick and thin blood films remains the gold standard for laboratory diagnosis, rapid antigen tests and nucleic acid amplification methods may also play a useful role in detection of acute infection. This review discusses the advantages and disadvantages of the commonly used diagnostic methods and provides important practice points for optimal malaria test utilization. […] The clinical features of malaria are nonspecific and overlap significantly with those of other febrile illnesses. Therefore, the WHO recommends that all patients have a parasite-specific laboratory test performed to confirm the clinical impression. […] Regardless of the method used, testing should be available and performed on a STAT basis 24 hours/day, 7 days/week due to the potentially life-threatening nature of the infection. The most commonly used methods for laboratory diagnosis of malaria are microscopic examination of stained blood films and detection of parasite antigen or nucleic acid. Of these, microscopic examination of thick and thin blood films remains the gold standard for malaria diagnosis.

• #1 Communicable Diseases Module: 7. Diagnosis of Malaria: View as single page | OLCreate

  https://www.open.edu/openlearnworks/mod/oucontent/view.php?id=90&printable=1

  7.5 Explain how microscopic examination is used to diagnose malaria and state its advantages over RDTs. […] By learning how to identify malaria with clinical diagnosis (and confirm it with RDTs) you will be able to provide effective and prompt treatment of malaria to patients at the community level. […] The most important symptom of malaria is fever (or a history of fever within the last two to three days). […] If untreated (or inadequately treated), malaria can cause several weeks or months of poor health because of repeated attacks of fever, anaemia and general weakness. […] A critical feature that may help you to recognise if a fever is due to malaria or not is that malarial fever occurs in cycles. […] The national malaria diagnosis policy in Ethiopia is that Health Extension Workers and Practitioners must test anyone suspected of having malaria by using the RDT for malaria.

• #1 Malaria Workup: Approach Considerations, Blood Smears, Alternatives to Blood Smear Testing

  https://emedicine.medscape.com/article/221134-workup

  The presentation of malaria is non-specific (ie, headache, fever, chills, myalgia, nausea, vomiting, diarrhea, fatigue, abdominal pain, altered mentation), and no combination of signs or symptoms can accurately discriminate malaria from other causes of fever in an endemic area. However, malaria should be suspected in any patient presenting with fevers greater than 99.5 degrees Fahrenheit in an endemic area without other obvious cause, as a delay in diagnosis is associated with increased mortality. […] Malaria should be suspected in children if they present with anemia and hemoglobin of less than 8g/dL. The 2 common methods used for parasitological diagnosis include light microscopy and immunochromatographic rapid diagnostic tests that detect parasite-specific proteins, which are discussed in depth below.

• #1 Severe Malaria Diagnosis | Severe Malaria Observatory

  https://www.severemalaria.org/severe-malaria/severe-malaria-diagnosis

  As severe malaria is the progression of uncomplicated malaria, its diagnosis is similar to that of uncomplicated malaria plus observations of danger signs. […] The most important element in the clinical diagnosis of malaria is a high index of suspicion. […] Where microscopy is unavailable or unfeasible, a rapid diagnostic test (RDT) should be used. […] In the absence of diagnostic facilities, a patient diagnosed with severe malaria based on clinical suspicion should be started on antimalarial treatment without delay, while other diagnoses are also considered. […] Monitoring of parasitaemia, at least every 12h, is important during the first 23 days of treatment in order to assess parasite response to the antimalarial medicine, especially in South-East Asia where resistance to artemisinin and the partner drugs is emerging.

• #1 Malaria: Causes, Symptoms, Diagnosis, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15014-malaria

  Malaria is a serious disease that spreads when youre bitten by a mosquito infected by Plasmodium parasites. When it bites, the mosquito injects malaria parasites into your bloodstream. […] Without treatment, malaria can cause brain damage, organ failure and death. See a healthcare provider right away if you live in or have traveled to an area where malaria spreads and you have symptoms. […] A healthcare provider will examine you and ask about your symptoms and travel history. Its important to let them know what countries youve visited recently so they can clearly understand your risk. […] Your provider will take a sample of your blood and send it to a lab to see if you have Plasmodium parasites. The blood test will tell your provider if you have malaria and will also identify the Plasmodium species. Theyll use this information to determine the right treatment.

• #1 Malaria – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/malaria/diagnosis-treatment/drc-20351190

  To diagnose malaria, your doctor will likely review your medical history and recent travel, conduct a physical exam, and order blood tests. Blood tests can indicate: […] The presence of the parasite in the blood, to confirm that you have malaria […] Which type of malaria parasite is causing your symptoms […] If your infection is caused by a parasite resistant to certain drugs […] Whether the disease is causing any serious complications. […] Some blood tests can take several days to complete, while others can produce results in less than 15 minutes. Depending on your symptoms, your doctor may order additional diagnostic tests to assess possible complications.

• #1 Malaria Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/primary-care/malaria/diagnosis.html

  How is malaria diagnosed? The doctor will ask you questions about your health and do a physical exam. If the doctor thinks you may have malaria, he or she will use a blood smear to check for the disease. During this test, a sample of blood is placed on a glass slide, prepared, and looked at under a microscope. […] A blood smear test can help diagnose malaria. It can also help a doctor see what type of malaria parasite you have and how many parasites are in your blood. This can help with decisions about treatment. […] If the first blood smear doesn’t show malaria, your doctor may order more tests every 12 to 24 hours. […] A blood test that can diagnose malaria quickly is also available. If this rapid test points to malaria, the results are usually confirmed with a blood smear. […] If you’ve been in an area where malaria occurs and you get a fever up to a year after you return, your doctor may test you for malaria. If the tests don’t show malaria, you may need more tests to make sure that you don’t have a malaria infection. During treatment, tests are repeated to follow the course of the infection and to see if the treatment is working.

• #1 Malaria Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/primary-care/malaria/diagnosis.html

  Other useful tests that may be done include: Polymerase chain reaction (PCR). This test detects parasite nucleic acids and identifies the species of malaria parasite. […] Complete blood count (CBC). This checks for anemia or evidence of other possible infections. Anemia sometimes develops in people with malaria, because the parasites damage red blood cells.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Malaria-Diagnosis.aspx

  Diagnosis of malaria is made with the help of microscopic examination of the blood samples. The symptoms of malaria may resemble flu, gastroenteritis, typhoid, or other viral fevers. Thus fever and other symptoms similar to malaria need careful evaluation to diagnose malaria. […] Early diagnosis is important to ensure appropriate, presumptive, and accurate treatment and to reduce the risk of life-threatening complications and death. A blood sample is usually taken for diagnosis. […] Thick and thin blood smears are taken on a glass slide. The samples best show a confirmatory diagnosis during a bout of fever when the parasite is present in the peripheral bloodstream. The smears on the glass slides are then stained with Giemsa stain. The slides are viewed under the microscope and the parasite is identified. This is the gold standard method of diagnosis and remains one of the cheapest and most cost-effective methods. Other advantages include high sensitivity and specificity when used by well-trained staff. Where the blood film is negative, at least 2 further films should be obtained over the next 48 hours before malaria is ruled out. A negative report does not necessarily mean the individual has no malaria. This is particularly the case in pregnancy when the parasites remain clustered in the placenta and may not be easily detected.

• #1 Malaria Workup: Approach Considerations, Blood Smears, Alternatives to Blood Smear Testing

  https://emedicine.medscape.com/article/221134-workup

  A diagnosis of malaria should be supported by the identification of the parasites on a thin or thick blood smear. […] Three thick and thin smears 12-24 hours apart should be obtained. When reading a smear, a minimum of 200 high-power fields should be examined by 2 trained observers (more if the patient recently has taken prophylactic medication, because this temporarily may decrease parasitemia). One negative smear does not exclude malaria as a diagnosis; several more smears should be examined over a 36-hour period. […] Alternative diagnostic methods typically are used if the laboratory does not have sufficient expertise in detecting parasites in blood smears. […] Rapid diagnostic tests (RDTs) are portable tests that detect parasite-specific antigens in a blood sample for malaria diagnosis.

• #1 CDC – DPDx – Malaria – Diagnostic Findings

  http://med.iiab.me/modules/en-cdc/www.cdc.gov/dpdx/malaria/dx.html

  Microscopy (morphologic analysis) continues to be the „gold standard” for malaria diagnosis. Parasites may be visualized on both thick and thin blood smears stained with Giemsa, Wright, or Wright-Giemsa stains. Giemsa is the preferred stain, as it allows for detection of certain morphologic features (e.g. Schffners dots, Maurers clefts, etc.) that may not be seen with the other two. Ideally, the thick smears are used to detect the presence of parasites while the thin smears are used for species-level identification. Quantification may be done on both thick and thin smears. […] Morphologic characteristics of malaria parasites can determine a parasite species, however, microscopists may occasionally fail to differentiate between species in cases where morphologic characteristics overlap (especially Plasmodium vivax and P. ovale), as well as in cases where parasite morphology has been altered by drug treatment or improper storage of the sample. In such cases, the Plasmodium species can be determined by using confirmatory molecular diagnostic tests. In addition, molecular tests such as PCR can detect parasites in specimens where the parasitemia may be below the detectable level of blood film examination.

• #1 Diagnosis of malaria – Wikipedia

  https://en.wikipedia.org/wiki/Diagnosis_of_malaria

  Multiple recent studies have documented malaria overdiagnosis as a persistent issue globally, but especially in African countries. […] Overdiagnosis results in over-inflation of actual malaria rates reported at the local and national levels. […] Health facilities tend to over-diagnose malaria in patients presenting with symptoms such as fever, due to traditional perceptions such as „any fever being equivalent to malaria” and issues related to laboratory testing. […] Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria. […] Using Giemsa-stained blood smears from children in Malawi, one study showed that when clinical predictors were used as treatment indications, rather than using only a history of subjective fevers, a correct diagnosis increased from 2% to 41% of cases.

• #1 Advances in Malaria Diagnostic Methods in Resource-Limited Settings: A Systematic Review

  https://www.mdpi.com/2414-6366/9/9/190

  Technologies for malaria diagnosis have advanced in recent years; however, certain factors, such as the lack of laboratory infrastructure, operational costs, electricity requirements, and special operation expertise, have impeded the implementation of these advanced techniques in the vast majority of malaria endemic areas. […] The WHO describes microscopy (thin and thick film) as the primary method of detection. […] Other concerns have been the invasive approach of this technique, where blood samples are collected after a painful pierce of a needle, and yet an accurate diagnosis unassuredly relies solely on the discretion of the laboratory scientist. […] In several developing countries, there is inadequate expertise, equipment, and supplies required for accurate detection; as such, there are greater risks of contamination and false diagnosis.

• #1 Malaria diagnosis in rural healthcare facilities and treatment-seeking behavior in malaria endemic settings in western Kenya | PLOS Global Public Health

  https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0001532

  The World Health Organization recommends that all suspected malaria cases be confirmed through microscopy or the use of rapid diagnostic test kits before antimalarial drugs are administered. […] Although we did not re-examine to confirm the accuracy of clinically diagnosed cases, it was apparent that dispensaries that relied on clinical diagnosis reported a significantly higher number of malaria cases than those that used microscopy.

• #1

  https://www.sysmex-europe.com/academy/knowledge-centre/infectious-diseases/malaria/

  Developed for a quick identification of malaria parasites in endemic countries where the laboratory workload is very high, rapid diagnostic tests (RDT) can also be used as a parasitological test to confirm the diagnosis, as per the WHO guidelines. […] Medical guidelines in endemic African countries require the use of microscopy where it is applicable, mainly in well-equipped tertiary health institutions. […] For primary or secondary care, an RDT can be the first diagnostic tool, but only as an alternative or complementary to microscopy. […] Medical guidelines in non-endemic countries state that a positive RDT must always be followed up by microscopical examination. […] Molecular techniques such as PCR are not part of the WHO guidelines, due to insufficient standardisation and validation, but local guidelines in non-endemic countries reserve a role for PCR for the identification of Plasmodium species in highly specialised reference laboratories.

• #1 Malaria – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/161

  Malaria typically presents with non-specific symptoms such as fever, chills, sweats, headache, and myalgia. […] In Western countries, almost all malaria occurs in travellers; therefore, the diagnosis may be missed if a history of travel is not elicited. […] Microscopic examination of a Giemsa-stained blood film remains the diagnostic test of choice; however, immunochromatographic tests are also used in many centres. […] Once the diagnosis of malaria is confirmed, treatment should be started urgently, as a delay may be associated with disease progression and complications. […] Diagnostic investigations include Giemsa-stained thick and thin blood smears, rapid diagnostic tests (RDTs), and a full blood count (FBC). […] Investigations to consider include polymerase chain reaction (PCR) blood for malaria and chest x-ray. […] Emerging tests include loop-mediated isothermal amplification.

• #1 Chapter 6 – Malaria diagnosis: Canadian recommendations for the prevention and treatment of malaria – Canada.ca

  https://www.canada.ca/en/public-health/services/catmat/canadian-recommendations-prevention-treatment-malaria/chapter-6-malaria-diagnosis.html

  Only microscopy can provide reliable speciation and parasitemia. Results are important for definitive management. All labs should endeavour to have a protocol for providing microscopy results within a few hours. […] PCR can provide very accurate speciation, especially for mixed infections, but is not commercialized and not easily or rapidly available for most centres in Canada. […] All suspected cases of malaria should have a parasitologic test to confirm the diagnosis. […] Blood should be examined immediately for malaria if it is suspected. If expertise in reading malaria smears is not available, diagnosis should involve the local use of an RDT and/or LAMP and then the rapid transfer of a blood sample to a reference laboratory. […] RDTs or LAMP should be available in every clinical laboratory facility in Canada that might receive specimens for malaria diagnosis. RDTs or LAMP should be offered as the first line test, unless high quality malaria microscopy results can be made available within 2 hours of receipt of the specimens.

• #1 Chapter 6 – Malaria diagnosis: Canadian recommendations for the prevention and treatment of malaria – Canada.ca

  https://www.canada.ca/en/public-health/services/catmat/canadian-recommendations-prevention-treatment-malaria/chapter-6-malaria-diagnosis.html

  Because of the potential risks associated with misdiagnosis of falciparum malaria CATMAT recommends that all patients suspected of having malaria who have a negative HRP2-based RDT test for Plasmodium falciparum have samples tested by an alternative method such as microscopy or nucleic acid amplification.

• #1 Malaria: Prevention, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/malaria.html

  Each year, malaria causes an estimated 500,000 deaths worldwide. […] The accurate, timely, and species-specific diagnosis of malaria is essential for successful treatment. Direct microscopy of Giemsa-stained blood smears is the reference standard for laboratory diagnosis. […] Rapid testing for malaria has emerged as an important adjunctive diagnostic modality. […] All febrile travelers who have recently returned from a malarious area should be evaluated for malaria. […] The clinical presentation of malaria ranges from asymptomatic parasitemia or uncomplicated disease to severe disease or death. […] In the absence of a detailed travel history, malaria is often misdiagnosed as a nonspecific viral illness. […] Travelers who have symptoms of malaria should seek medical attention as soon as possible, regardless of whether prophylaxis or preventive measures were used.

• #1 Advancements and Challenges in Malaria Diagnostics | IntechOpen

  https://www.intechopen.com/online-first/1218680

  Diagnostic methods are vital for dealing with the global malaria burden and decreasing malaria incidence. The diagnosis by microscopy is considered a gold standard; however, rapid diagnostic tests (RDTs) have become a primary diagnostic test in many malaria-endemic areas. […] The diagnosis of malaria can be achieved through various diagnostic methods such as light microscopy, PCR-based tests, Rapid diagnostic tests (RDTs), etc. […] The development of novel technologies based on artificial intelligence and image analysis is revolutionizing malaria diagnostics by automating the diagnostic process and reducing reliance on expert microscopists. […] Light microscopy has been in use for over a century and is considered the standard method for malaria diagnosis. […] The RDTs overcome all the major problems associated with microscopy and have been found to be very useful in endemic areas, but recently, problems have been observed with the currently available RDTs as well.

• #1 Non-invasive malaria screening device uses light for diagnosis | Hub

  https://hub.jhu.edu/2023/01/06/researchers-develop-non-invasive-screening-malaria/

  Non-invasive malaria screening device uses light for diagnosis. The test, being developed by a research team led by Johns Hopkins engineer Ishan Barman, is seen as an alternative to current rapid tests that require blood draws. A team led by a Johns Hopkins engineer is developing an alternative: a rapid diagnostic test that uses light to diagnose the often deadly disease – no blood draws or finger pricks needed. „With our proposed method, there are no invasive finger-pricks. Instead, we are working on a way to diagnose whether a person has malaria through non-invasive measurements using near-infrared light,” said team leader Ishan Barman, an associate professor of mechanical engineering in the Whiting School of Engineering. Without any blood draws or sample preparation, the device can be used to screen for malaria outside of a clinical setting, such as in schools or community centers. Barman’s team improves on that model through the development of a hand-held screening device that can scan a patient’s arm or finger to detect the presence of malaria, eliminating the need to draw blood. Called ParaSpy Plus, the technology depends on an optical fiber probe that combines two spectroscopy modalities, label-free Raman spectroscopy and diffuse reflectance spectroscopy, or DRS, to noninvasively quantify malaria parasites in red blood cells. Thanks to the fiber probe, Raman and DRS measurements are sequentially performed in vivo without sampling blood. When collected by the device, the measurements will then directly feed into artificial intelligence algorithms that can provide a quick and accurate diagnosis. The team plans to integrate its new sensing technology and AI software into a single portable screening device. The team expects that at the end of the three-year project period, the prototype will be ready for large-scale validation via clinical studies in different malaria-endemic regions.

• #1 Malaria 101 – 'D’ is for DIAGNOSIS and rapid treatment: The faster, the better | University of Pretoria

  https://www.up.ac.za/faculty-of-health-sciences/news/post_3194869-malaria-101-d-is-for-diagnosis-and-rapid-treatment-the-faster-the-better

  Malaria, a potentially fatal disease, demands swift action when its symptoms surface. The disease can progress rapidly and lead to severe complications, so early diagnosis and treatment are essential. […] Knowing the A, B, C, Ds of malaria is crucial for prevention, early detection, and effective treatment. D is for DIAGNOSIS and treatment. This article underscores the significance of immediate healthcare intervention when a positive diagnosis is made following the onset of malaria symptoms. […] Malaria is diagnosed through a combination of clinical evaluation and laboratory tests. The common methods for diagnosis include blood smear microscopy, rapid diagnostic tests (RDTs), or polymerase chain reaction (PCR) tests, to confirm the presence of the parasite and identify the species. The choice of diagnostic method depends on factors such as availability of resources, expertise of healthcare personnel, and specific circumstances of the patient.

• #1 Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola | Parasites & Vectors | Full Text

  https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-024-06467-3

  Accurate and early diagnosis of malaria is of great importance for effective treatment and correct management of the disease. […] The main diagnostic methods for malaria are based on the identification of parasitic forms by microscopic examination of blood smears, detection of antigens by rapid diagnostic tests (RDTs), or nucleic acids by molecular methods, such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). […] Microscopic examination remains the gold standard technique for malaria diagnosis as it allows for the quantification and identification of Plasmodium species in blood samples. […] Currently, molecular methods, mainly based on PCR protocols, serve as relevant tools for the diagnosis of malaria due to their high sensitivity and specificity, as they are able to detect the presence of parasite DNA in asymptomatic patients or those with very low parasite loads (detection limit 1 parasite/L).

• #1 Malaria: Prevention, Diagnosis, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/malaria.html

  The accurate, timely, and species-specific diagnosis of malaria is essential for successful treatment. Microscopic examination of Giemsa-stained blood smears is the reference standard for laboratory diagnosis. […] Rapid testing for malaria has emerged as an important adjunctive diagnostic modality. Rapid diagnostic tests have excellent sensitivity and negative predictive value with results available in five to 20 minutes. […] In the United States, rapid diagnostic tests for malaria should be used only in conjunction with thick and thin blood smears.

• #1 Malaria 101 – 'D’ is for DIAGNOSIS and rapid treatment: The faster, the better | University of Pretoria

  https://www.up.ac.za/faculty-of-health-sciences/news/post_3194869-malaria-101-d-is-for-diagnosis-and-rapid-treatment-the-faster-the-better

  In conclusion, early malaria diagnosis and treatment can prevent severe complications and save lives. By emphasising the importance of swift action and improving access to healthcare services, significant strides can be made against malaria. […] Early diagnosis and treatment by a healthcare practitioner saves lives.

• #2 Laboratory tools for diagnosis of malaria – UpToDate

  https://www.uptodate.com/contents/laboratory-tools-for-diagnosis-of-malaria

  Laboratory tools for diagnosis of malaria […] Prompt and accurate diagnosis of malaria is critical for implementation of appropriate treatment to reduce associated morbidity and mortality. Accurate detection of malaria is also important for epidemiologic screening and surveillance to inform malaria control strategies, for research purposes in testing efficacy of antimalarial drugs and vaccines, and for blood bank screening. […] Characteristics of a useful malaria diagnostic tool include the ability to definitively establish presence or absence of infection, determine which species of malaria is/are present, quantify parasitemia (ie, parasites per microliter of blood or percent red blood cells infected), detect low-level parasitemia, and allow monitoring of response to antimalarial therapy (including detection of recrudescence or relapse). Thus far, there is no single malaria diagnostic tool that meets all of these criteria. Test characteristics that are important for diagnosis vary depending on the epidemiology of infection and goals for control in the region where the test is used. […] Tools for diagnosis of malaria will be reviewed here.

• #2 Update on Malaria Diagnostics and Test Utilization

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5483902/

  Malaria is a potentially life-threatening disease requiring rapid diagnosis and treatment. Although microscopic examination of thick and thin blood films remains the gold standard for laboratory diagnosis, rapid antigen tests and nucleic acid amplification methods may also play a useful role in detection of acute infection. This review discusses the advantages and disadvantages of the commonly used diagnostic methods and provides important practice points for optimal malaria test utilization. […] The clinical features of malaria are nonspecific and overlap significantly with those of other febrile illnesses. Therefore, the WHO recommends that all patients have a parasite-specific laboratory test performed to confirm the clinical impression. […] Regardless of the method used, testing should be available and performed on a STAT basis 24 hours/day, 7 days/week due to the potentially life-threatening nature of the infection. The most commonly used methods for laboratory diagnosis of malaria are microscopic examination of stained blood films and detection of parasite antigen or nucleic acid. Of these, microscopic examination of thick and thin blood films remains the gold standard for malaria diagnosis.

• #2 Update on Malaria Diagnostics and Test Utilization

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5483902/

  It is important to note that examination of a single set of blood films may be insufficient for malaria diagnosis, particularly with low levels of parasitemia. The Clinical and Laboratory Standards Institute (CLSI) recommends that repeat blood films be obtained and examined every 6 to 8 h for up to 3 days (if clinically indicated) until malaria is definitively excluded from the differential diagnosis. […] The thick film should be examined first for parasites, and the thin film used to identify organisms to the species level. Both the thick and thin films should be examined at 100 magnification with oil immersion for a minimum of 100 fields, and up to at least 300 fields for immunologically naive patients (i.e., those without previous Plasmodium exposure), as they may present with symptoms at a lower level of parasitemia.

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