Format

Send to

Choose Destination
Crit Rev Clin Lab Sci. 2016;53(2):87-105. doi: 10.3109/10408363.2015.1084991. Epub 2015 Sep 17.

Molecular malaria diagnostics: A systematic review and meta-analysis.

Author information

1
a Royal Tropical Institute (KIT), KIT Biomedical Research , Amsterdam , The Netherlands .
2
b Department of Clinical Epidemiology, Biostatistics and Bioinformatics , Academic Medical Center , Amsterdam , The Netherlands , and.
3
c Department of Infectious Diseases, Division of Internal Medicine , Center of Tropical Medicine and Infectious Diseases, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.

Abstract

Accurate diagnosis of malaria is essential for identification and subsequent treatment of the disease. Currently, microscopy and rapid diagnostic tests are the most commonly used diagnostics, next to treatment based on clinical signs only. These tests are easy to deploy, but have a relatively high detection limit. With declining prevalence in many areas, there is an increasing need for more sensitive diagnostics. Molecular tools may be a suitable alternative, although costs and technical requirements currently hamper their implementation in resource limited settings. A range of (near) point-of-care diagnostics is therefore under development, including simplifications in sample preparation, amplification and/or read-out of the test. Accuracy data, in combination with technical characteristics, are essential in determining which molecular test, if any, would be the most promising to be deployed. This review presents a comprehensive overview of the currently available molecular malaria diagnostics, ranging from well-known tests to platforms in early stages of evaluation, and systematically evaluates their published accuracy. No important difference in accuracy was found between the most commonly used PCR-based assays (conventional, nested and real-time PCR), with most of them having high sensitivity and specificity, implying that there are no reasons other than practical ones to choose one technique over the other. Loop-mediated isothermal amplification and other (novel) diagnostics appear to be highly accurate as well, with some offering potential to be used in resource-limited settings.

KEYWORDS:

Diagnostic test accuracy; Plasmodium; loop-mediated isothermal amplification; microscopy; molecular diagnostic; point-of-care; polymerase chain reaction; rapid diagnostic test

PMID:
26376713
DOI:
10.3109/10408363.2015.1084991
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center