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MALARIA DIAGNOSISQUICK UPDATE

DR IAN MARR, NSW HEALTH PATHOLOGY

AUGUST 2018

MALARIA TESTING

• Microscopy

• RDT

• LAMP

Microscopy captured 87% of RDT-

positive infections, with higher test

concordance in children than in adults

Nature volume 528, pages S86–S93 (03 December 2015)

doi.org/10.1038/nature16039

Imwong et al. Malar J (2015) 14:381

DOI 10.1186/s12936-015-0906-x

Britton et al. Malar J (2016) 15:88

DOI 10.1186/s12936-016-1158-0

Available at

https://ailabs.tw/healthcare/ai-malaria-taiwan/

RDT

• LDH - lactate dehydrogenase

• HRP2 - histidine-rich protein 2 (HRP2)

….pan-Aldolase

MALARIA RDT SELECTION

http://apps.who.int/iris/bitstream/handle/10665/258597/

9789241512916-

eng.pdf;jsessionid=76C8FD0C4EFA8894DAA5FB76C8

F46AEF?sequence=1

MALARIA INTERACTIVE GUIDE - RDT

• http://www.finddx.org/malaria

/interactive-guide/

• http://www.rdt-interactive-

guide.org/

WHAT IS NECESSARY?

• WHO guidelines suggest the following for selection of the best RDT

HEAD TO HEAD…..

SENSITIVITY

200

parasite/uL

Pf

SENSITIVITY

200

parasites/uL

Pv

SENSITIVITY

2000-5000

parasites / uL

Pf

SENSITIVITY

2000-5000

parasites / uL

Pv

CareStart™ Malaria

HRP2/pLDH (Pf/PAN)

COMBOj

90.0% 94.3% 100.0% 100.0%

SD BIOLINE Malaria Ag

Pf/Pv

92.0% 94.3% 100.0% 100.0%

http://www.rdt-interactive-guide.org/

MOLECULAR TOOLS

• NAATS

• PCR-ELISA

• nucleic acid lateral flow immunoassay (NALFIA)

• nested PCR-high resolution melting analysis (nPCR-

HRM)

• PCR-ligase detection reaction assays (PCR-LDR)

• LDR- fluorescent microsphere assay (LDR-FMA)

Isothermal

• LAMP (see below)

• NASBA

• tHDA

• RPA

LAMP

Review| Volume 31, ISSUE 8, P391-400, August 01, 2015

https://doi.org/10.1016/j.pt.2015.04.006