The impact of malaria on global health has continually prompted the need to develop more effective diagnostic strategies that could overcome deficiencies in accurate and early detection. In this review, we examine the various biosensor-based methods for malaria diagnostic biomarkers, namely; Plasmodium falciparum histidine-rich protein 2 (PfHRP-2), parasite lactate dehydrogenase (pLDH), aldolase, glutamate dehydrogenase (GDH), and the biocrystal hemozoin. The models that demonstrate a potential for field application have been discussed, looking at the fabrication and analytical performance characteristics, including (but not exclusively limited to): response time, sensitivity, detection limit, linear range, and storage stability, which are first summarized in a tabular form and then described in detail. The conclusion summarizes the state-of-the-art technologies applied in the field, the current challenges and the emerging prospects for malaria biosensors.Sensors 2020, 20, 799 2 of 21 emergence and spread of drug resistance. It could also reduce the pool of individuals who can contribute to malaria transmission [5].To date, many technologies have attempted to circumvent the challenges in malaria diagnostics with technologies that address point-of-care needs and early stage asymptomatic detection. In this review, we first comprehensively summarize the biomarkers targeted during the course of malaria with emphasis on the importance of sensitive early detection. Next, we provide an overview of the recent advances in biosensor technologies for the detection of the most targeted biomarkers, focusing on: development, analytical performances, and suitability for point of care testing. The prevailing challenges and future outlook of the use of these technologies in the field are also highlighted.
Parasite Development in Humans, Biomarkers, and DiagnosisThe developmental cycle of Plasmodium species that infect humans is briefly illustrated in Figure 1 [6]. The cycle begins with the injection of sporozoites into the host's circulation by an infected female Anopheles mosquito. The sporozoites then target and enter hepatocytes where they multiply and differentiate into merozoites. This stage of the parasite life cycle is known as pre-erythrocytic. In infections involving P. vivax and P. ovale, dormant forms of the liver stage, called hypnozoites may persist in the liver [7] and cause relapse of the infection, thereby making it difficult to eradicate. The pre-erythrocytic stage is essential in the establishment of malaria infection. This stage is asymptomatic, however, it is difficult for diagnostic tools to detect sporozoites because hepatocytes invasion occurs within 30-45 min after sporozoites are inoculated by the infected mosquito [8,9]. This short time and low numbers of sporozoites injected leaves little time for their detection. Some efforts in finding biomarkers for detection of early liver stage or the dormant form have identified the Plasmodium liver-specific protein 2 (LISP2) [10,11]. The sporozoite surface circum...