Ensuring quality and access for malaria diagnosis: how can it be achieved?

  title={Ensuring quality and access for malaria diagnosis: how can it be achieved?},
  author={David R Bell and Chansuda Wongsrichanalai and John W. Barnwell},
  journal={Nature Reviews Microbiology},
The replacement of conventional antimalarial drugs with high-cost, artemisinin-based alternatives has created a gap in the successful management of malaria. This gap reflects an increased need for accurate disease diagnosis that cannot be met by traditional microscopy techniques. The recent introduction of rapid diagnostic tests (RDTs) has the potential to meet this need, but successful RDT implementation has been curtailed by poor product performance, inadequate methods to determine the… 

Recent Progress in the Development of Diagnostic Tests for Malaria

This minireview discusses some of the recent trends and new approaches that are seeking to improve the clinical diagnosis of malaria and suggests more efficient detection techniques with the potential of POC applications, especially in resource-limited settings.

Working without a blindfold: the critical role of diagnostics in malaria control

Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts.

Development of new malaria diagnostics: matching performance and need

Six market segments are identified: case management in low-resourced countries, parasite screening for low density infections in elimination programmes, surveillance for evidence of continued transmission, clinical research and therapeutic efficacy monitoring, cross-checking for microscopy quality control, and returned traveller markets distinguished primarily by resource availability.

Importance of quality assurance testing of malaria rapid diagnostic test in the case management of malaria

There is a clear and urgent need to address issues on quality performance and appropriateness of use of blood-based diagnosis using lateral-flow immunochromatographic tests, particularly in remote endemic areas.

Improved patient care with better malaria diagnosis

A push towards universal parasitological diagnosis will require major re-orientation of malaria control programs, and consideration of funding mechanisms to facilitate adequate malaria diagnosis prior to treatment, has implications for training, supervision, logistics, monitoring and quality control.


There was a difference in the performance characteristics of R DTs carried out in health facilities and at the cross sectional survey, however, when the analysis of sensitivity is based on parasite density, the performance of RDTs in both health facility study and during cross sectionsal survey is comparable to expert microscopy.

Parasite-based confirmation of malaria with rapid diagnostic tests: Challenges and Advantages

  • C. Okangba
  • Medicine
    Scientific Journal of Pure and Applied Sciences
  • 2019
The key to effective case management of malaria is prompt and accurate diagnosis of malaria which is necessary to prevent morbidity and mortality. Accurate and practical malaria diagnostic such as

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This review addresses the quality issues with current malaria diagnostics and presents data from recent rapid diagnostic test trials.

Malaria diagnosis in the community: Challenges and potential role of rapid diagnostic tests (RDTs) in the African Region.

At present, malaria rapid diagnostic tests (RDTs) are widely available and used in parts of Asia and Latin America. In Africa, their use has been limited mainly to private health facilities. With the

Accuracy of malaria rapid diagnosis test Optimal-IT® in Kinshasa, the Democratic Republic of Congo

Although microscopy is considered as the "gold standard" for malaria diagnosis at point of care level, this study showed that its accuracy may not always be satisfactory when performed in health centres.



Non-microscopic method for malaria diagnosis using OptiMAL IT, a second-generation dipstick for malaria pLDH antigen detection

Sensitivity and specificity for detection of all malaria species for both tests were comparable but loss of sensitivity of the test strips due to humidity or temperature found with the routine use of OptiMAL 48 was not seen with the individualoptiMAL IT.

Imported malaria: prospective analysis of problems in diagnosis and management.

Most travelers who acquire malaria had sought pretravel advice from a physician; however, only 11% used recommended chemoprophylaxis and only 17% used insect protection measures.

Community-based program for malaria case management in the Brazilian Amazon.

It is demonstrated that dipstick testing can be used in a sustainable, community-based program that should be applicable in a wide variety of settings and not just in areas of drug-resistant malaria.

Trial of the ParaSight‐F test for malaria diagnosis in the primary health care system, Zimbabwe

It was found that the ParaSight‐F test reduced mistreatment for malaria, relative to clinical diagnosis, by up to 81%, especially in the hypoendemic region.

Letter to the Editor: Artemisinin‐based combination treatment in home‐based management of malaria

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Comparison of five methods of malaria detection in the outpatient setting.

The quantitative buffy coat (QBC) technique, acridine orange staining with an interference filter system, and the ParaSight-F test have been introduced as alternative methods to conventional microscopy for the diagnosis of malaria.

Malaria diagnosis and treatment under the strategy of the integrated management of childhood illness (IMCI): relevance of laboratory support from the rapid immunochromatographic tests of ICT Malaria P.f/P.v and OptiMal.

In holo-endemic areas, use of RIT or microscopical examination of bloodsmears may only be relevant when malaria needs to be excluded as a cause of illness, or during malaria epidemics, and treatment based on clinical diagnosis alone should prove cost-saving in health facilities without microscopy.

[Evaluation of the OptiMal test in the diagnosis of imported malarial outbreak].

The results of this study demonstrate that the current version of the OptiMal test should be used with great caution for the diagnosis of malarial infection in hospital practice.

Positive control wells: a potential answer to remote-area quality assurance of malaria rapid diagnostic tests.