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A Review of Malaria Diagnostic Tools: Microscopy and Rapid Diagnostic Test (RDT)

The absolute necessity for rational therapy in the face of rampant drug resistance places increasing importance on the accuracy of malaria diagnosis. Giemsa microscopy and rapid diagnostic tests (RDTs) represent the two diagnostics most likely to have the largest impact on malaria control today. These two methods, each with characteristic strengths and limitations, together represent the best hope for accurate diagnosis as a key component of successful malaria control. This review addresses the quality issues with current malaria diagnostics and presents data from recent rapid diagnostic test trials. Reduction of malaria morbidity and drug resistance intensity plus the associated economic loss of these two factors require urgent scaling up of the quality of parasite-based diagnostic methods. An investment in anti-malarial drug development or malaria vaccine development should be accompanied by a parallel commitment to improve diagnostic tools and their availability to people living in malarious areas.

Received August 21, 2006. Accepted for publication March 7, 2007.

Acknowledgments: The authors thank William O. Rogers and David Bell for their reviews and useful comments.

Disclaimer: The assertions herein are the views of the authors and do not reflect official policy of the U.S. Department of the Navy or the U.S. Department of Defense.

^* Address correspondence to Chansuda Wongsrichanalai, Office of Public Health, USAID/Regional Development Mission—Asia (US-AID/RDM-A), GPF Building, 3^rd Floor, 93/1 Wireless Road, Bangkok 10330, Thailand. E-mail: cwongsrichanalai{at}usaid.gov

Authors’ addresses: Chansuda Wongsrichanalai and Awalludin Sutamihardja, U.S. Naval Medical Research Unit No. 2 (NAMRU-2), Kompleks P2M/PLP-LITBANGKES, Jalan Percetakan Negara No. 29, Jakarta 10570, Republic of Indonesia. Tel: 62-21-421-4457. Mazie J. Barcus, 2061 Winged Foot Court, Reston, VA 20191. Sinuon Muth, National Center for Parasitology, Entomology and Malaria Control (CNM), Phnom Penh, Cambodia. Walther H. Wernsdorfer, Institute of Specific Prophylaxis and Tropical Medicine, Center for Physiology and Pathophysiology, Medical University of Vienna, Vienna, Austria.

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