MALARIA DIAGNOSIS - A REVIEW

Malaria is the most prevalent endemic disease in large parts of the wo rld and is subject to control by health authorities. Today, the goal o f malaria control is to prevent mortality and reduce morbidity and soc ioeconomic losses through the progressive improvement and strengthenin g of local and national capabilities. The World Health Organization co nsiders early diagnosis as the first basic element of the strategy to control the disease. Traditionally, laboratory diagnosis has been made using the thick blood film, which continues to be the gold standard t est. However, this test has disadvantages such as the manner in which the film is prepared, the level of training of the observer, the adequ acy of maintenance of materials and equipment and its only fair sensit ivity. Thus, many research laboratories have concentrated their effort s on the development of alternative methods for malaria diagnosis. The se include methods for the detection of Plasmodia within erythrocytes (fluorescent microscopy, Quantitative Buffy Coat (QBC(R)), dark field microscopy, nucleic acid probes and immunofluorescence), methods for t he detection of plasmodial antigens in body fluids (radioimmunoassay, enzyme immunoassay) and methods for the detection of anti-plasmodial a ntibodies in serum (indirect immunofluorescence, enzyme immunoassay, W estern blotting). Here, we critically review the various methods for m alaria diagnosis based on the world's literature and our experience wi th most of them, with emphasis on recent advances.