A Systematic Literature Review of Microscopy Methods Reported in Malaria Clinical Trials

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  • 1 Institute of Global Health, University of Geneva, Geneva, Switzerland;
  • 2 Infectious Diseases Data Observatory (IDDO), Oxford, United Kingdom;
  • 3 Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;
  • 4 Swiss Tropical and Public Health Institute, Basel, Switzerland;
  • 5 University of Basel, Basel, Switzerland;
  • 6 Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland

Microscopy of stained blood films is essential for the diagnosis of malaria, differentiation of parasite species, and estimation of parasite density performed for assessments of antimalarial drug efficacy. The accuracy and comparability of these measures over time and space are vital to discern the emergence or spread of antimalarial drug resistance. Although evidence-based guidelines for malaria microscopy methods exist, the age-old microscopy techniques for parasitological assessments are subject to considerable methodological variations. The purpose of this review was to explore critically how microscopy methods were reported in published malarial studies between 2013 and 2017 with the focus on outlining the methodological differences and improving reporting standards in practice.

Author Notes

Address correspondence to Debashish Das or Philippe J. Guerin, Infectious Diseases Data Observatory (IDDO), Centre for Tropical Medicine and Global Health, New Richards Bldg., Old Rd. Campus, Roosevelt Dr., Oxford OX3 7FZ, United Kingdom. E-mails: debashish.das@wwarn.org or philippe.guerin@wwarn.org

Disclosure: All the data used in this review are presented in the main text, either as tables/figures or as Supplemental Files. Raw data used for analysis are presented as Supplemental File 3. The R script used for processing the raw data and generating tables and figures presented in the main text is presented as Supplemental File 4.

Financial support: The WorldWide Antimalarial Resistance Network (WWARN) is funded by the Bill & Melinda Gates Foundation and the ExxonMobil Foundation.

Authors’ addresses: Debashish Das, Prabin Dahal, Barbara Wanjiru Citarella, Kalynn Kennon, Kasia Stepniewska, and Philippe J. Guerin, Infectious Diseases Data Observatory (IDDO), Centre for Tropical Medicine, University of Oxford, United Kingdom, and Nuffield Department of Medicine, Global Health, University of Oxford, United Kingdom, E-mails: debashish.das@wwarn.org, prabin.dahal@wwarn.org, barbara.citarella@wwarn.org, kalynn.kennon@wwarn.org, kasia.stepniewska@wwarn.org, and philippe.guerin@wwarn.org. Mehul Dhorda, Infectious Diseases Data Observatory (IDDO), Asia-Pacific Regional Centre, Bangkok, Thailand, Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, United Kingdom, and Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, E-mail: mehul.dhorda@wwarn.org. Ingrid Felger, Swiss Tropical and Public Health Institute, Basel, Switzerland, E-mail: ingrid.felger@swisstph.ch. François Chappuis, Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland, E-mail: francois.chappuis@hcuge.ch.

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