Novel techniques and future directions in molecular diagnosis of malaria in resource-limited settings

Abstract

Despite being preventable and treatable, malaria remains a global health concern with approximately 1.2 billion people at high risk of being infected, 90% of whom are in the resource-limited settings of sub-Saharan Africa. The continued decline in malaria cases globally has rekindled the possibility of elimination in certain regions. As humans constitute the main reservoir of malaria, prompt and accurate diagnosis by microscopy or rapid diagnostic tests is part not only of effective disease management but also of control measures. However, for malaria elimination, more sensitive diagnostic tools are needed to detect asymptomatic and sub-microscopic infections that contribute to transmission. Molecular techniques, which involve amplification of nucleic acids, are being developed and modified to suit this purpose. This report provides a summary of the nucleic acid amplification tests that are currently available for diagnosis of malaria, with current improvements and adaptations for use in resource-limited settings.

A Field-Tailored Reverse Transcription Loop-Mediated Isothermal Assay for High Sensitivity Detection of Plasmodium falciparum Infections

“…Malaria diagnosis is currently conducted by light microscopy (thick or thin blood smears), by using one of several existing antigen-based lateral flow immunological tests (commonly referred to as rapid diagnostic tests or RDTs),or using nucleic acid amplification-based tests (NAATs) such as polymerase chain reaction (PCR) or isothermal amplification techniques [17, 18]. Of these, light microscopy remains the gold standard given that a positive result, if accurately interpreted, proves an active infection with malaria parasites.…”

Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings

“…76–82 The Nanomal (QuantuMDx), Accutas (Aquila Diagnostic Systems Inc.), and DiscoGnosis LabDisk system (IMTEK) all require minimal infrastructure and sample preparation and can be used at the POC. However, cost may be prohibitive for low-resource settings, with the lowest estimated per-test cost at $2–$4 and high equipment costs.…”

“…82 Other promising inexpensive malaria NATs are being developed which integrate sample preparation to reduce potential contamination, do not require cold chain storage, and have limits of detection appropriate for highly sensitive testing. 76,79,81 In addition, two commercially available imaging-based tests, the Rapid Assessment of Malaria (RAM) Device (Disease Diagnostic Group Inc.) and Magneto-optical Device (MOD) (Meditopian LLC), detect submicroscopic infections in under one minute for less than $1 per test, with minimal sample preparation and rechargeable batteries to reduce infrastructure requiremnents, although the equipment cost for RAM is high. 82 Finally, a few highly sensitive protein-based methods for submicroscopic malaria detection have also been reviewed.…”

“…82 Finally, a few highly sensitive protein-based methods for submicroscopic malaria detection have also been reviewed. 76,82–85 These tests are low-cost, easy-to-use, and do not require electricity to run, making them suitable for use at the POC. While several of the above tests may be appropriate for submicroscopic detection in low-resource settings, their diagnostic performance for malaria in pregnancy has yet to be fully validated.…”

Epigenetics Changes in Breast Cancer: Current Aspects in India

“…Burden of various diseases always hampered the progress of human civilization especially in the third world countries [31,32]. Advanced techniques are being utilized to understand various disease conditions, chronological alteration of disease causes for various life threatening diseases including infectious diseases such as malaria [33][34][35][36], different bacterial diseases such as tuberculosis and others [37][38][39], viral diseases such as Dengue, Chikungunya, West Nile etc.…”