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Clinical Microbiology Reviews, January 2002, p. 66-78, Vol. 15, No. 1
0893-8512/02/$04.00+0     DOI: 10.1128/CMR.15.1.66-78.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Rapid Diagnostic Tests for Malaria Parasites

Anthony Moody* Malaria presents a diagnostic challenge to laboratories in most countries. Endemic malaria, population movements, and travelers all contribute to presenting the laboratory with diagnostic problems for which it may have little expertise available. Drug resistance and genetic variation has altered many accepted morphological appearances of malaria species, and new technology has given an opportunity to review available procedures. Concurrently the World Health Organization has opened a dialogue with scientists, clinicians, and manufacturers on the realistic possibilities for developing accurate, sensitive, and cost-effective rapid diagnostic tests for malaria, capable of detecting 100 parasites/µl from all species and with a semiquantitative measurement for monitoring successful drug treatment. New technology has to be compared with an accepted Rgold standardS that makes comparisons of sensitivity and specificity between different methods. The majority of malaria is found in countries where cost-effectiveness is an important factor and ease of performance and training is a major consideration. Most new technology for malaria diagnosis incorporates immunochromatographic capture procedures, with conjugated monoclonal antibodies providing the indicator of infection. Preferred targeted antigens are those which are abundant in all asexual and sexual stages of the parasite and are currently centered on detection of HRP-2 from Plasmodium falciparum and parasite-specific lactate dehydrogenase or Plasmodium aldolase from the parasite glycolytic pathway found in all species. Clinical studies allow effective comparisons between different formats, and the reality of nonmicroscopic diagnoses of malaria is considered.

* Mailing address: Department of Clinical Parasitology, Hospital for Tropical Diseases, University College Hospital, Mortimer Market, Capper St., London WC1E 6AU, United Kingdom. Phone: 0207 387 9300, ext. 5411. Fax: 0207 383 0041. E-mail: anthony.moody{at}uclh.org.

Clinical Microbiology Reviews, January 2002, p. 66-78, Vol. 15, No. 1
0893-8512/02/$04.00+0     DOI: 10.1128/CMR.15.1.66-78.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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