Molecular Diagnostic Tools and Malaria Elimination: A Review on Solutions at Hand, Challenges Ahead and Breakthroughs Needed

Abstract

Malaria is a serious public health problem worldwide. Globally concerted efforts are underway to control and eliminate it. Despite recent slowdown, substantial achievements have been recorded in the last 20 years. However, its eradication requires successful elimination of all <i>Plasmodium</i> parasites among symptomatic, asymptomatic, and sub-microscopic infections. This review is aimed at assessing the role of molecular diagnostic tools in malaria elimination. Quality assured malaria diagnosis is fundamental to control and elimination of malaria. High-throughput molecular diagnostic tools are important for the diagnosis, and monitoring of interventions to mitigate malaria. Molecular techniques such as real-time PCR, LAMP, nPCR, RT-PCR, multiplex-PCR, NASBA, and CLIP-PCR have been instrumental for malaria control and elimination. They enabled the detection and identification of symptomatic, asymptomatic, and sub-microscopic parasitemia. They are also important in the discovery, and development of drugs. Despite their tremendous contribution and immense potential, they are not readily available in malaria-endemic settings, fail to detect hypnozoites and infectious gametocytes as well as not sufficiently optimized for fieldwork. Those challenges might delay malaria elimination thereby threatening the quest to reach the goal of a malaria-free world by 2050. Therefore, we need novel tools fit for field application and for detecting hypnozoites, infectious gametocytes, and in vitro analysis of <i>Plasmodium vivax</i>.