Introductory Chapter: Malaria in 2022 – Promises and Unmet Needs

Abstract

Another serology test employed is an immune-enzymatic assay, used principally for blood donors screening. The limit of this test is its sensitivity due to the possibility to detect only P. falciparum vs "non-falciparum spp." Nucleic acid detection methodsTo date, only a few referral laboratories use molecular methods to detect, define, and quantify Plasmodium infections, while these tests are principally used for research and epidemiologic scopes [12]. Only for a suspect of P. knowlesi infection, polymerase chain reaction (PCR) is becoming a standard to confirm the diagnosis before treatment initiation.PCR-based techniques could be useful to detect malaria in case of infection at lowdensity parasitemia, which is difficult to detect also at microscopy or in the absence of an expert technician. Of note, the specific oligonucleotides used for the amplification allow, at the same time, detection, species definition and quantitation, even for low amounts of Plasmodia [13][14][15][16][17]. Prospectively, PCR-based tools are expected to be the gold standard in malaria diagnosis, as already happened in most infectious diseases. In fact, PCR is currently cheap, easy to perform even in low resources settings, fast, and absolutely accurate.Loop-mediated isothermal amplification test (LMPA) can detect parasite DNA in a simpler way with respect to PCR [18][19][20][21][22]. The advantages of LMPA tests, compared with PCR, are that thermocyclers are not required. Conversely, sensitivity and specificity are variable, making this test not always reliable [23][24][25][26].