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TRANSCRIPT
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