The Role of Ultrasensitive Molecular Methods for Detecting Malaria—The Broader Perspective

Kamaliddin, Claire; Sutherland, Colin J.; Houzé, Sandrine; Cottrell, Gilles; Briand, Valérie; Mogollon, Daniel Castaneda; Pillai, Dylan R.

doi:10.1093/cid/ciab221

Cited by 12 publications

(8 citation statements)

References 42 publications

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“…Third, we continue to strengthen laboratory network and actively promote nucleic acid detection methods for malaria parasites with the help of the nucleic acid testing laboratory platform at different levels established under the COVID-19 pandemic [ 38 ] and improve the sensitivity and specificity of malaria parasite detection from the front line. At the same time, it is necessary to develop more sensitive, specific, and rapid detection technologies or kits suitable for clinical use [ 35 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Malaria Microscopy Competency in the Subnational Verification, China: Implications for Malaria Elimination and the Prevention of Malaria Reestablishment

Huang

Yin

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Introduction. Qualified microscopy competency is a key indicator for certification of malaria elimination. To better prepare the country certification and identify the priorities that need improvement to prevent malaria reestablishment, microscopy competency at different levels were assessed in subnational verification of malaria elimination in China. Methodology. Microscopist representatives from centers for disease control and prevention (CDC)/institutes of parasitic diseases (IPD) and medical institutes for malaria diagnosis at the provincial and county levels in the subnational verification were analyzed. Specifically, five provincial microscopist representatives and ten county-level representatives were assessed in each of previously endemic provinces on qualitative identification (Plasmodium positive or negative) and Plasmodium species identification using standard slides from the National Malaria Diagnosis Reference Laboratory. Results. A total of 100 provincial-level representatives (60 from 42 CDCs/IPDs and 40 from 34 medical institutes) and 200 county-level representatives (61 from 41 CDCs and 139 from 118 medical institutes) were included. The qualitative accuracy was higher than 90% each ( P = 0.137 ), but slides with low parasite density were easy to be misdiagnosed as negative. Furthermore, the accuracy of species identification was 80.0% and 83.6% in medical institutes and centers for disease control and prevention (CDCs) at the provincial level ( P = 0.407 ) with relatively high misdiagnosis of P. vivax as P. ovale in the latter (16.2%) and 82.0% and 85.0% in medical institutes and CDCs at the county level ( P = 0.330 ) for the identification of P. falciparum and non-P. falciparum with higher false-negative in medical institutions ( P < 0.001 ). Conclusions. In conclusion, competent microscopy in subnational verification supported the quality in eliminating malaria in China, while the accurate identification of malaria parasites, especially slides with low parasite density still need to be improved through continuous diagnostic platform construction, continuous technological innovation, and targeted training to prevent reestablishment of malaria transmission.

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Section: Discussionmentioning

confidence: 99%

Malaria Microscopy Competency in the Subnational Verification, China: Implications for Malaria Elimination and the Prevention of Malaria Reestablishment

Huang

Yin

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Similarly, improved diagnostics are necessary to address challenges such as the rise of HRP2/3 gene deletions [32] or poor validity of existing diagnostics in low-transmission settings [33]. Ultra-sensitive malaria rapid diagnostic tests have been proposed to improve detection under low transmission intensities or low parasite densities but risk biasing clinical management away from other febrile illnesses [34]. From a health systems perspective, the introduction of new diagnostic tools must therefore be part of a broader strategy for case finding and management, instead of purely focusing on the tools.…”

Section: Address Weaknesses In Health Systems To Maximize the Effecti...mentioning

confidence: 99%

What Africa can do to accelerate and sustain progress against malaria

Okumu

Gyapong

Casamitjana

et al. 2022

PLOS Glob Public Health

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After a longstanding global presence, malaria is now largely non-existent or suppressed in most parts of the world. Today, cases and deaths are primarily concentrated in sub-Saharan Africa. According to many experts, this persistence on the African continent reflects factors such as resistance to insecticides and drugs as well as insufficient access to essential commodities such as insecticide-treated nets and effective drugs. Crucially, however, this narrative ignores many central weaknesses in the fight against malaria and instead reinforces a narrow, commodity-driven vision of disease control. This paper therefore describes the core challenges hindering malaria programs in Africa and highlights key opportunities to rethink current strategies for sustainable control and elimination. The epidemiology of malaria in Africa presents far greater challenges than elsewhere and requires context-specific initiatives tailored to national and sub-national targets. To sustain progress, African countries must systematically address key weaknesses in its health systems, improve the quality and use of data for surveillance-responses, improve both technical and leadership competencies for malaria control, and gradually reduce overreliance on commodities while expanding multisectoral initiatives such as improved housing and environmental sanitation. They must also leverage increased funding from both domestic and international sources, and support pivotal research and development efforts locally. Effective vaccines and drugs, or other potentially transformative technologies such as genedrive modified mosquitoes, could further accelerate malaria control by complementing current tools. However, our underlying strategies remain insufficient and must be expanded to include more holistic and context-specific approaches critical to achieve and sustain effective malaria control.

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“…When quantitative real-time PCR (qPCR) technology was first introduced, it was considered revolutionary for the molecular diagnosis of malaria. It is in fact more sensitive than other conventional PCR methods (LOD < 0.1 parasites/µL) [ 18 ] and easier to execute with no post-PCR manipulations. In practice, two main types of qPCRs exist: the ones using fluorescent dyes such as SYBR green which intercalates with nonspecific double-stranded DNA and the ones with specific fluorescent probes such as TaqMan probes [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of two commercial kits and two laboratory-developed qPCR assays compared to LAMP for molecular diagnosis of malaria

Bouzayene

Zaffaroullah

Bailly

et al. 2022

Malar J

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Background Malaria is an infectious disease considered as one of the biggest causes of mortality in endemic areas. This life-threatening disease needs to be quickly diagnosed and treated. The standard diagnostic tools recommended by the World Health Organization are thick blood smears microscopy and immuno-chromatographic rapid diagnostic tests. However, these methods lack sensitivity especially in cases of low parasitaemia and non-falciparum infections. Therefore, the need for more accurate and reliable diagnostic tools, such as real-time polymerase chain reaction based methods which have proven greater sensitivity particularly in the screening of malaria, is prominent. This study was conducted at the French National Malaria Reference Centre to assess sensitivity and specificity of two commercial malaria qPCR kits and two in-house developed qPCRs compared to LAMP. Methods 183 blood samples received for expertise at the FNMRC were included in this study and were subjected to four different qPCR methods: the Biosynex Ampliquick® Malaria test, the BioEvolution Plasmodium Typage test, the in-house HRM and the in-house TaqMan qPCRs. The specificity and sensitivity of each method and their confidence intervals were determined with the LAMP-based assay Alethia® Malaria as the reference for malaria diagnosis. The accuracy of species diagnosis of the Ampliquick® Malaria test and the two in-house qPCRs was also evaluated using the BioEvolution Plasmodium Typage test as the reference method for species identification. Results The main results showed that when compared to LAMP, a test with excellent diagnostic performances, the two in-house developed qPCRs were the most sensitive (sensitivity at 100% for the in-house TaqMan qPCR and 98.1% for the in-house HRM qPCR), followed by the two commercial kits: the Biosynex Ampliquick® Malaria test (sensitivity at 97.2%) and the BioEvolution Plasmodium Typage (sensitivity at 95.4%). Additionally, with the in-house qPCRs we were able to confirm a Plasmodium falciparum infection in microscopically negative samples that were not detected by commercial qPCR kits. This demonstrates that the var genes of P. falciparum used in these in-house qPCRs are more reliable targets than the 18S sRNA commonly used in most of the developed qPCR methods for malaria diagnosis. Conclusion Overall, these results accentuate the role molecular methods could play in the screening of malaria. This may represent a helpful tool for other laboratories looking to implement molecular diagnosis methods in their routine analysis, which could be essential for the detection and treatment of malaria carriers and even for the eradication of this disease.

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The Role of Ultrasensitive Molecular Methods for Detecting Malaria—The Broader Perspective

Cited by 12 publications

References 42 publications

Malaria Microscopy Competency in the Subnational Verification, China: Implications for Malaria Elimination and the Prevention of Malaria Reestablishment

Malaria Microscopy Competency in the Subnational Verification, China: Implications for Malaria Elimination and the Prevention of Malaria Reestablishment

What Africa can do to accelerate and sustain progress against malaria

Evaluation of two commercial kits and two laboratory-developed qPCR assays compared to LAMP for molecular diagnosis of malaria

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