135:
228:") have been developed, distributed and fieldtested. These tests use finger-stick or venous blood, the completed test takes a total of 15–20 minutes, and the results are read visually as the presence or absence of colored stripes on the dipstick, so they are suitable for use in the field. The threshold of detection by these rapid diagnostic tests is in the range of 100 parasites/μL of blood (commercial kits can range from about 0.002% to 0.1% parasitemia) compared to 5 by thick film microscopy. One disadvantage is that dipstick tests are qualitative but not quantitative
156:
the microscopist to screen a larger volume of blood and are about eleven times more sensitive than the thin film, so picking up low levels of infection is easier on the thick film, but the appearance of the parasite is much more distorted and therefore distinguishing between the different species can be much more difficult. 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.
322:
presenting with symptoms such as fever, due to traditional perceptions such as "any fever being equivalent to malaria" and issues related to laboratory testing (for example high false positivity rates of diagnosis by unqualified personnel ). Malaria overdiagnosis leads to under management of other fever-inducing conditions, over-prescription of antimalarial drugs and exaggerated perception of high malaria endemicity in regions which are no longer endemic for this infection.
111:
1714:
87:
63:
300:
PCR (and other molecular methods) is more accurate than microscopy. However, it is expensive, and requires a specialized laboratory. Moreover, levels of parasitemia are not necessarily correlative with the progression of disease, particularly when the parasite is able to adhere to blood vessel walls.
155:
because each of the four major parasite species has distinguishing characteristics. Two sorts of blood film are traditionally used. Thin films are similar to usual blood films and allow species identification because the parasite's appearance is best preserved in this preparation. Thick films allow
367:
In cases of extremely low white blood cell count, it may be difficult to perform a manual differential of the various types of white cells, and it may be virtually impossible to obtain an automated differential. In such cases the medical technologist may obtain a buffy coat, from which a blood smear
363:
Quantitative buffy coat (QBC) is a laboratory test to detect infection with malaria or other blood parasites. The blood is taken in a QBC capillary tube which is coated with acridine orange (a fluorescent dye) and centrifuged; the fluorescing parasites can then be observed under ultraviolet light at
330:
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 (rectal temperature, nailbed pallor, and splenomegaly)
321:
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
171:
As malaria becomes less prevalent due to interventions such as bed nets, the importance of accurate diagnosis increases. This is because the assumption that any patient with a fever has malaria becomes less accurate. As such, significant research is being put into developing low cost microscopy
312:
have published a preclinical study of their new tech that can detect even a single malaria-infected cell among a million normal cells. They claim it can be operated by nonmedical personal, produce zero false-positive readings, and it doesn't need a needle or any damage done.
167:
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.
253:
are used, this type of assay can distinguish between different species of human malaria parasites, because of antigenic differences between their pLDH isoenzymes. Antibody tests can also be directed against other malarial antigens such as the
28:
have been discovered, though these are not widely implemented in malaria endemic regions. Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria.
24:. 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
331:
were used as treatment indications, rather than using only a history of subjective fevers, a correct diagnosis increased from 2% to 41% of cases, and unnecessary treatment for malaria was significantly decreased.
765:
Pattanasin S, Proux S, Chompasuk D, Luwiradaj K, Jacquier P, Looareesuwan S, Nosten F (2003). "Evaluation of a new
Plasmodium lactate dehydrogenase assay (OptiMAL-IT) for the detection of malaria".
1701:
364:
the interface between red blood cells and buffy coat. This test is more sensitive than the conventional thick smear, however it is unreliable for the differential diagnosis of species of parasite.
216:
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.
1691:
308:
that is found in malaria parasites feasting on red blood cells, but not found in normal blood cells. It can be faster, simpler and precise than any other method. Researchers at
1072:
Yegorov, Sergey; Galiwango, Ronald M.; Ssemaganda, Aloysious; Muwanga, Moses; Wesonga, Irene; Miiro, George; Drajole, David A.; Kain, Kevin C.; Kiwanuka, Noah (2016-11-14).
857:
949:
Reyburn, Hugh; Mbatia, Redepmta; Drakeley, Chris; Carneiro, Ilona; Mwakasungula, Emmanuel; Mwerinde, Ombeni; Saganda, Kapalala; Shao, John; Kitua, Andrew (2004-11-20).
1013:
Mwanziva, Charles; Shekalaghe, Seif; Ndaro, Arnold; Mengerink, Bianca; Megiroo, Simon; Mosha, Frank; Sauerwein, Robert; Drakeley, Chris; Gosling, Roly (2008-11-05).
347:
does not ensure a diagnosis of severe malaria, because parasitemia can be incidental to other concurrent disease. Recent investigations suggest that malarial
351:
is better (collective sensitivity of 95% and specificity of 90%) than any other clinical or laboratory feature in distinguishing malarial from non-malarial
1239:
Adeoye GO, Nga IC (December 2007). "Comparison of
Quantitative Buffy Coat technique (QBC) with Giemsa-stained Thick Film (GTF) for diagnosis of malaria".
1133:"Prescription practices for malaria in Mozambique: poor adherence to the national protocols for malaria treatment in 22 public health facilities"
798:
796:
640:
1596:
198:, so it is important to identify and treat infections quickly. Therefore, modern methods such as PCR (see "Molecular methods" below) or
1651:
301:
Therefore, more sensitive, low-tech diagnosis tools need to be developed in order to detect low levels of parasitemia in the field.
1292:
1015:"Overuse of artemisinin-combination therapy in Mto wa Mbu (river of mosquitoes), an area misinterpreted as high endemic for malaria"
1681:
1676:
531:"Detection and identification of human Plasmodium species with real-time quantitative nucleic acid sequence-based amplification"
1534:
854:
221:
211:
134:
1618:
1696:
1671:
1469:
385:
Krafts K, Hempelmann E, Oleksyn B (2011). "The color purple: from royalty to laboratory, with apologies to
Malachowski".
1581:
1335:
1074:"Low prevalence of laboratory-confirmed malaria in clinically diagnosed adult women from the Wakiso district of Uganda"
873:"Hemozoin-generated vapor nanobubbles for transdermal reagent- and needle-free detection of malaria", Ekaterina Y. L.,
278:
1646:
1686:
294:
290:
25:
1613:
1462:
803:
Redd S, Kazembe P, Luby S, Nwanyanwu O, Hightower A, Ziba C, Wirima J, Chitsulo L, Franco C, Olivar M (2006).
1666:
1543:
1404:
1352:
892:"Multi-method assessment of patients with febrile illness reveals over-diagnosis of malaria in rural Uganda"
239:
665:"Optical Technologies for Improving Healthcare in Low-Resource Settings: introduction to the feature issue"
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1285:
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246:
217:
103:
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Molecular methods are available in some clinical laboratories and rapid real-time assays (for example,
1576:
1479:
1452:
1386:
1379:
951:"Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study"
890:
Ghai, Ria R.; Thurber, Mary I.; El Bakry, Azza; Chapman, Colin A.; Goldberg, Tony L. (2016-09-07).
199:
127:
1191:
1656:
1641:
1586:
836:
508:
410:
261:
Modern rapid diagnostic tests for malaria often include a combination of two antigens such as a
1603:
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1113:
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913:
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747:
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636:
611:
562:
500:
473:
451:
402:
151:
The most economic, preferred, and reliable diagnosis of malaria is microscopic examination of
1131:
Salomão, Cristolde A.; Sacarlal, Jahit; Chilundo, Baltazar; Gudo, Eduardo Samo (2015-12-01).
281:
of 100% and where possible, microscopic examination of blood films should also be performed.
1736:
1717:
1489:
1457:
1372:
1358:
1330:
1320:
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1211:
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737:
729:
684:
676:
601:
593:
552:
542:
492:
441:
394:
343:, leading to a failure to treat other life-threatening illnesses. In malaria-endemic areas,
79:
55:
1661:
1524:
1496:
861:
309:
110:
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is made. This smear contains a much higher number of white blood cells than whole blood.
1216:
1167:
1132:
1108:
1073:
1049:
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689:
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557:
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187:
983:
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panels that can distinguish between the two should be used in this part of the world.
1730:
1474:
1437:
1325:
840:
512:
414:
1608:
1447:
297:) are being developed with the hope of being able to deploy them in endemic areas.
173:
86:
62:
1252:
630:
398:
1548:
1484:
966:
348:
344:
160:
159:
From the thick film, an experienced microscopist can detect parasite levels (or
1553:
1529:
1419:
1414:
1342:
1207:
1149:
1090:
908:
496:
232:– they can determine if parasites are present in the blood, but not how many.
152:
21:
1192:"Malarial retinopathy: a newly established diagnostic sign in severe malaria"
1158:
1099:
1040:
974:
917:
878:
1558:
1409:
1394:
1031:
712:
McCutchan, Thomas F.; Piper, Robert C.; Makler, Michael T. (November 2008).
225:
1260:
1225:
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992:
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733:
698:
566:
547:
455:
406:
1190:
Beare NA, Taylor TE, Harding SP, Lewallen S, Molyneux ME (November 2006).
832:
615:
504:
663:
Bowden AK, Durr NJ, Erickson D, Ozcan A, Ramanujam N, Jacques PV (2020).
597:
472:
Ling I.T.; Cooksley S.; Bates P.A.; Hempelmann E.; Wilson R.J.M. (1986).
305:
265:. specific antigen e.g. histidine-rich protein II (HRP II) and either a
1315:
1301:
680:
17:
339:
Fever and septic shock are commonly misdiagnosed as severe malaria in
340:
804:
194:
parasitemia increases very fast and causes more severe disease than
446:
429:
20:
diagnosis has been the microscopic examination of blood, utilizing
1501:
632:
Tropical infectious diseases: principles, pathogens & practice
164:
352:
277:
species which affect humans e.g. pLDH. Such tests do not have a
1274:
1442:
629:
Richard L. Guerrant; David H. Walker; Peter F. Weller (2006).
1702:
European and
Developing Countries Clinical Trials Partnership
133:
109:
85:
61:
1270:
855:
Vapor nanobubbles rapidly detect malaria through the skin
1692:
The Global Fund to Fight AIDS, Tuberculosis and
Malaria
529:
Mens PF; Schoone GJ; Kager PA; Schallig HDFH (2006).
1634:
1569:
1512:
1430:
1308:
190:) look very similar under the microscope. However,
714:"Use of Malaria Rapid Diagnostic Test to Identify
430:"Detecting malaria parasites outside the blood"
474:"Antibodies to the glutamate dehydrogenase of
186:(which is the most common cause of malaria in
1286:
8:
524:
522:
467:
465:
235:The first rapid diagnostic tests were using
1293:
1279:
1271:
1215:
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1148:
1107:
1089:
1048:
1030:
982:
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907:
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688:
605:
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242:as antigen. PGluDH was soon replaced by
36:
377:
1008:
1006:
1004:
1002:
805:"Clinical algorithm for treatment of
7:
1597:National Malaria Eradication Program
306:iron crystal byproduct of hemoglobin
1652:Bill & Melinda Gates Foundation
273:LDH or an antigen sensitive to all
635:. Elsevier Churchill Livingstone.
304:Another approach is to detect the
14:
582:"Laboratory diagnosis of malaria"
580:Warhurst DC, Williams JE (1996).
428:Sutherland CJ, Hallett R (2009).
1713:
1712:
1682:African Leaders Malaria Alliance
1677:South African Malaria Initiative
1535:Malaria antigen detection tests
212:Malaria antigen detection tests
1619:Malaria in Mandatory Palestine
222:Malaria Rapid Diagnostic Tests
1:
1697:Medicines for Malaria Venture
1672:African Malaria Network Trust
825:10.1016/S0140-6736(96)90404-3
779:10.1016/S0035-9203(03)80100-1
1582:Millennium Development Goals
1253:10.1016/j.parint.2007.06.007
722:Emerging Infectious Diseases
399:10.3109/10520295.2010.515490
224:, Antigen-Capture Assay or "
967:10.1136/bmj.38251.658229.55
955:BMJ (Clinical Research Ed.)
767:Transact Royal Soc Trop Med
249:(pLDH). Depending on which
1753:
1647:Against Malaria Foundation
209:
1710:
1687:Amazon Malaria Initiative
1208:10.4269/ajtmh.2006.75.790
1150:10.1186/s12936-015-0996-5
1091:10.1186/s12936-016-1604-z
909:10.1186/s12936-016-1502-4
669:Biomedical Optics Express
497:10.1017/S0031182000064088
295:polymerase chain reaction
26:polymerase chain reaction
1614:Malaria in the Caribbean
1463:Sterile insect technique
163:) as few as 5 parasites/
1667:Africa Fighting Malaria
1513:Diagnosis and treatment
1032:10.1186/1475-2875-7-232
879:10.1073/pnas.1316253111
359:Quantitative buffy coat
240:glutamate dehydrogenase
1431:Control and prevention
734:10.3201/eid1411.080840
548:10.1186/1475-2875-5-80
317:Over- and misdiagnosis
269:specific antigen e.g.
138:
114:
90:
66:
1624:Malaria Atlas Project
1196:Am. J. Trop. Med. Hyg
807:Plasmodium falciparum
476:Plasmodium falciparum
251:monoclonal antibodies
247:lactate dehydrogenase
218:Immunochromatographic
137:
113:
104:Plasmodium falciparum
89:
65:
1520:Diagnosis of malaria
1336:Pregnancy-associated
809:malaria in children"
598:10.1136/jcp.49.7.533
326:Subjective diagnosis
220:tests (also called:
1577:Diseases of poverty
1570:Society and malaria
1480:Sickle-cell anaemia
1453:Malaria prophylaxis
716:Plasmodium knowlesi
200:monoclonal antibody
180:Plasmodium malariae
128:Plasmodium malariae
1657:Imagine No Malaria
1642:Malaria Consortium
1587:History of malaria
1470:Genetic resistance
1395:Anopheles mosquito
860:2014-01-08 at the
681:10.1364/BOE.397698
263:P. falciparum
256:P. falciparum
172:solutions for the
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1724:
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1604:World Malaria Day
642:978-0-443-06668-9
387:Biotech Histochem
285:Molecular methods
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49:Liver persistent
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1490:G6PDH deficiency
1458:Mosquito control
1331:Blackwater fever
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864:", news.rice.edu
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675:(6): 3091–3094.
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196:P. malariae
192:P. knowlesi
184:P. knowlesi
80:Plasmodium ovale
56:Plasmodium vivax
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16:The mainstay of
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896:Malaria Journal
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862:Wayback Machine
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819:(8996): 223–7.
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1247:(4): 308–12.
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1609:Epidemiology
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1448:Mosquito net
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485:Parasitology
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434:J Infect Dis
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174:Global South
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46:Periodicity
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1592:Roman fever
1549:Artemisinin
1485:Thalassemia
393:(1): 7–35.
349:retinopathy
345:parasitemia
279:sensitivity
161:parasitemia
153:blood films
43:Appearance
33:Blood films
22:blood films
1554:Mefloquine
1530:Blood film
1420:Gametocyte
1415:Hypnozoite
1400:Life cycle
1366:falciparum
1353:life cycle
1343:Plasmodium
1084:(1): 555.
902:(1): 460.
718:Infection"
541:(80): 80.
372:References
275:plasmodium
244:Plasmodium
237:Plasmodium
210:See also:
1559:Proguanil
1410:Merozoite
1159:1475-2875
1100:1475-2875
1041:1475-2875
975:1756-1833
918:1475-2875
226:Dipsticks
1731:Category
1718:Category
1405:Schizont
1387:knowlesi
1380:malariae
1321:Cerebral
1261:17683979
1226:17123967
1177:26628068
1118:27842555
1059:18986520
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936:27604542
858:Archived
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699:32637243
567:17018138
513:16953840
456:19432543
415:19829220
407:21235291
291:QT-NASBA
142:quartan
118:tertian
94:tertian
70:tertian
40:Species
1737:Malaria
1348:biology
1316:Malaria
1309:Biology
1302:Malaria
1217:2367432
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1373:ovale
1359:vivax
875:et al
837:S2CID
509:S2CID
481:(PDF)
411:S2CID
1257:PMID
1222:PMID
1173:PMID
1155:ISSN
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1096:ISSN
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783:PMID
748:PMID
695:PMID
650:2011
637:ISBN
612:PMID
563:PMID
501:PMID
452:PMID
403:PMID
353:coma
182:and
73:yes
1443:DDT
1249:doi
1212:PMC
1204:doi
1163:PMC
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963:doi
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602:PMC
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