Evaluation of diagnostic methods of re-emerging malaria in Korean patients

Malaria is one of the most important parasitic diseases especially in tropi cal areas. Over 300 million people are affected and the condition causes 1- 3 million deaths each year. It is transmitted by the bite of infected Anoph eles mosquitoes. Although Korea was declared to be free of Malaria by the W HO in 1979, malaria re-emergence has been apparent since 1993 amongst soldi ers located near the De-Militarized Zone (DMZ) in the northern part of the country. Conventional microscopic examination of thin and thick blood films demonstr ates the presence of the parasite and thus this method has been used to con firm the diagnosis of malaria, but it is a labor-intensive procedure and re lies upon subjective interpretation. To overcome these limitations, fast an d reliable methods for malaria detection have been recently introduced. In this study, we compared three kinds of antibody detection kits and one bioc hemical test kit that determines the presence of Plasmodium lactate dehydro genase (LDH) with conventional peripheral blood smears. The antibody detect ion methods examined were, two rapid test pack format methods and a single microplate format enzyme-linked immunosorbent assay (ELISA) kit, as manufac tured by Korean companies. The sensitivities of the three commercial antibody detection kits in the ea rly stage of malaria were 70.8%, 77.4%, and 63.6%, their corresponding spec ificities 90.5%, 91.8%, and 80.9%, and their accuracies 87.6%, 87.0%, and 7 6.7%. The sensitivity and specificity of the pLDH assay were 100% apiece an d the results were in 100% concordance with the microscopy of thick blood f ilms. Thus, the pLDH assay may be used as an alternative for conventional microsc opic blood film examination, especially in emergency situations when prompt treatment is necessary.