Validity and reliability of methods to microscopically detect and quantify malaria parasitaemia

Mischlinger, Johannes; Pitzinger, Paul; Veletzky, Luzia; Groger, Mirjam; Zoleko-Manego, Rella; Adegnika, Ayôla Akim; Agnandji, Selidji Todagbé; Lell, Bertrand; Kremsner, Peter G.; Mombo-Ngoma, Ghyslain; Mordmüller, Benjamin; Ramharter, Michael

doi:10.1111/tmi.13124

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…A variety of diagnostic tools exists for the detection of malaria in blood (135)(136)(137)(138)(139)(140)(141)(142)(143). Depending on the available resources, it may be feasible to use highly sensitive and specific methods, such as PCR, loop-mediated amplification (LAMP), or enzyme-linked immunosorbent assay (ELISA) (137,141,(143)(144)(145)(146).…”

Section: Diagnosis Of Plasmodium Infections In Non-malaria-endemic Comentioning

confidence: 99%

“…Therefore, malaria light microscopy and rapid diagnostic tests (RDTs) are the most commonly applied methods for rapid ascertainment of malaria in clinical routine. Both can yield diagnostic results quickly and at high validity, implying that assays have high values in diagnostic sensitivity and specificity (135,138,148,149). However, due to its versatility, favorable diagnostic performance, and rapidity with which diagnostic results can be obtained, expert light microscopy is still regarded the gold standard in clinical routines (135,149,150).…”

Section: Diagnosis Of Plasmodium Infections In Non-malaria-endemic Comentioning

confidence: 99%

“…Due to the differing parasitological characteristics of presenting patients, it is important that routine diagnostic tools are capable of detecting a high parasite density as well as a (very) low one. For light microscopy, diagnostic sensitivity has a correlation with parasite density, with a theoretical limit of detection of ten parasites per microliter, while in reality the limit of detection is higher depending on the skill and training of the microscopist (135). To enhance diagnostic sensitivity, repeated testing of blood sam-ples being sampled in 12-to 24-h intervals has been recommended (116).…”

Section: Challenges In Detecting Infections Of Very Low and Very Highmentioning

confidence: 99%

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Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers

et al. 2020

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SUMMARY The continuous increase in long-distance travel and recent large migratory movements have changed the epidemiological characteristics of imported malaria in countries where malaria is not endemic (here termed non-malaria-endemic countries). While malaria was primarily imported to nonendemic countries by returning travelers, the proportion of immigrants from malaria-endemic regions and travelers visiting friends and relatives (VFRs) in malaria-endemic countries has continued to increase. VFRs and immigrants from malaria-endemic countries now make up the majority of malaria patients in many nonendemic countries. Importantly, this group is characterized by various degrees of semi-immunity to malaria, resulting from repeated exposure to infection and a gradual decline of protection as a result of prolonged residence in non-malaria-endemic regions. Most studies indicate an effect of naturally acquired immunity in VFRs, leading to differences in the parasitological features, clinical manifestation, and odds for severe malaria and clinical complications between immune VFRs and nonimmune returning travelers. There are no valid data indicating evidence for differing algorithms for chemoprophylaxis or antimalarial treatment in semi-immune versus nonimmune malaria patients. So far, no robust biomarkers exist that properly reflect anti-parasite or clinical immunity. Until they are found, researchers should rigorously stratify their study results using surrogate markers, such as duration of time spent outside a malaria-endemic country.

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Section: Diagnosis Of Plasmodium Infections In Non-malaria-endemic Comentioning

confidence: 99%

Section: Diagnosis Of Plasmodium Infections In Non-malaria-endemic Comentioning

confidence: 99%

Section: Challenges In Detecting Infections Of Very Low and Very Highmentioning

confidence: 99%

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Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers

et al. 2020

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“…Median (IQR) IVC-CI on enrolment was increased in malaria patients (42% [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]) relative to healthy participants (35% [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]; p = 0.01), but was similar between patients with severe (38% ) and uncomplicated malaria (44% [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]; p = 0.055). The share of p...…”

Section: Markers Of Clinical Severitymentioning

confidence: 99%

Point-of-care ultrasound to assess volume status and pulmonary oedema in malaria patients

et al. 2021

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Purpose Fluid management is challenging in malaria patients given the risks associated with intravascular fluid depletion and iatrogenic fluid overload leading to pulmonary oedema. Given the limitations of the physical examination in guiding fluid therapy, we evaluated point-of-care ultrasound (POCUS) of the inferior vena cava (IVC) and lungs as a novel tool to assess volume status and detect early oedema in malaria patients. Methods To assess the correlation between IVC and lung ultrasound (LUS) indices and clinical signs of hypovolaemia and pulmonary oedema, respectively, concurrent clinical and sonographic examinations were performed in an observational study of 48 malaria patients and 62 healthy participants across age groups in Gabon. Results IVC collapsibility index (CI) ≥ 50% on enrolment reflecting intravascular fluid depletion was associated with an increased number of clinical signs of hypovolaemia in severe and uncomplicated malaria. With exception of dry mucous membranes, IVC-CI correlated with most clinical signs of hypovolaemia, most notably sunken eyes (r = 0.35, p = 0.0001) and prolonged capillary refill (r = 0.35, p = 0.001). IVC-to-aorta ratio ≤ 0.8 was not associated with any clinical signs of hypovolaemia on enrolment. Among malaria patients, a B-pattern on enrolment reflecting interstitial fluid was associated with dyspnoea (p = 0.0003), crepitations and SpO2 ≤ 94% (both p < 0.0001), but not tachypnoea (p = 0.069). Severe malaria patients had increased IVC-CI (p < 0.0001) and more B-patterns (p = 0.004) on enrolment relative to uncomplicated malaria and controls. Conclusion In malaria patients, POCUS of the IVC and lungs may improve the assessment of volume status and detect early oedema, which could help to manage fluids in these patients.

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“…Laboratory methods. Microscopic malaria was diagnosed by thick blood smear (TBS), and the parasitaemia was quantified using the Lambaréné method [15]. Diagnosis of urinary schistosomiasis was based on the microscopic detection of S. haematobium eggs in urine, using the filtration method [16].…”

Section: Study Site Population and Proceduresmentioning

confidence: 99%

Maternal malaria but not schistosomiasis is associated with a higher risk of febrile infection in infant during the first 3 months of life: A mother-child cohort in Benin

Agbota¹,

Polman²,

Wieringa³

et al. 2019

PLoS ONE

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Validity and reliability of methods to microscopically detect and quantify malaria parasitaemia

Abstract: The LAMBA has higher validity than the sWHO and may therefore be preferable in resource-limited settings without access to routine WBC-evaluation.

Cited by 10 publications

References 21 publications

Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers

Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers

Point-of-care ultrasound to assess volume status and pulmonary oedema in malaria patients

Maternal malaria but not schistosomiasis is associated with a higher risk of febrile infection in infant during the first 3 months of life: A mother-child cohort in Benin

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