Accurate Diagnosis Of Malaria Research Articles

Comparison of Nested PCR and Conventional Analysis of <i>Plasmodium</i> Parasites in Kano, Nigeria

<i>Plasmodium</i> identification represents the crucial factor in malaria diagnosis and treatment across developing countries. Conventional microscopy and the use of rapid diagnostic kits have been extensively applied towards human malaria diagnosis. Recombinant DNA techniques have been applied towards malaria diagnosis as well as in the species specific identification using <i>Plasmodium</i> 18s-rRNA gene. This study was undertaken amongst patients attending the Murtala Mohammed Specialist Hospital, Kano. Blood samples were collected from 350 malaria suspected patients. Microscopic analysis via Giemsa-staining revealed that 220 patients were positive for malaria. RDT analysis showed that 248 test samples were positive for <i>Plasmodium</i> infection. DNA products obtained from the blood samples were analyzed by nested PCR to amplify the 18S ssrRNA <i>Plasmodium</i> gene with genus and specific primers rPLU1/5, rPLU3/4, rVIV1/2, rFAL1/2, rMAL1/2 and rOVA1/2. Data obtained showed that 58.64% of specimens tested by microscopy were false positives while 60.62% of false positives were obtained using RDTs in comparison to nPCR which proved that on 91 out of 350 patients were infected with <i>Plasmodium falciparum</i>, representing 26% of tested specimen. Comparative analysis of nPCR to microscopy showed that the sensitivity and positive predictive values of the nPCR were determined as 100 and 41.36%, respectively, while against RDTs it was 100 and 39.38% respectively. nPCR was determined to be more sensitive and specific than either microscopy or RDTs. This study revealed that the accurate diagnosis of malaria by nPCR was compulsory in malaria-prone regions of Nigeria such that nPCR should be applied routinely in laboratory studies.

細胞チップを用いた迅速高感度マラリア感染症診断法の開発

マラリアの制圧のためには、正確・高感度・迅速かつ易操作な診断方法の開発が必須である。我々はこれらを可能にし得るマイクロチップ技術を応用したデバイスを開発し、実際にマラリア流行地でその有用性を示すことができた。マラリア原虫を検出するためのマイクロチップ（細胞チップと呼ぶ）には約2万個のマイクロチャンバーが並ぶ。患者の血液から白血球を除去後、細胞チップ上で静置することで、200万個以上の赤血球がマイクロチャンバー内で単層に並び、蛍光核酸染色試薬および蛍光検出機を用いることで、マラリア原虫の高感度検出および感染率の算出が短時間で可能になった。

細胞チップを用いた迅速高感度マラリア感染症診断法の開発

細胞チップを用いた迅速高感度マラリア感染症診断法の開発

Advances in Molecular Diagnosis of Malaria.

Malaria is a mosquito-borne disease caused by five species of Plasmodium parasites. Accurate diagnosis of malaria plays an essential part in malaria control. With traditional diagnostic methodologies, malaria control programs have achieved remarkable success during the past decade, and are now heading toward malaria elimination in many areas. This new situation, however, calls for novel diagnostics with improved sensitivity, throughput, and reduced cost for active screening of malaria parasites, as all transfected individuals have to be identified in order to block transmission. In this chapter, we provide a brief introduction of malaria, the requirement of diagnostic advances in the age of malaria elimination, and a comprehensive overview of the currently available molecular malaria diagnostics, ranging from well-known tests to platforms in early stages of evaluation. We also discussed several practical issues for the application of molecular tests in malaria identification.

Two-stage sample-to-answer system based on nucleic acid amplification approach for detection of malaria parasites

Rapid, early, and accurate diagnosis of malaria is essential for effective disease management and surveillance, and can reduce morbidity and mortality associated with the disease. Although significant advances have been achieved for the diagnosis of malaria, these technologies are still far from ideal, being time consuming, complex and poorly sensitive as well as requiring separate assays for sample processing and detection. Therefore, the development of a fast and sensitive method that can integrate sample processing with detection of malarial infection is desirable. Here, we report a two-stage sample-to-answer system based on nucleic acid amplification approach for detection of malaria parasites. It combines the Dimethyl adipimidate (DMA)/Thin film Sample processing (DTS) technique as a first stage and the Mach-Zehnder Interferometer-Isothermal solid-phase DNA Amplification (MZI-IDA) sensing technique as a second stage. The system can extract DNA from malarial parasites using DTS technique in a closed system, not only reducing sample loss and contamination, but also facilitating the multiplexed malarial DNA detection using the fast and accurate MZI-IDA technique. Here, we demonstrated that this system can deliver results within 60min (including sample processing, amplification and detection) with high sensitivity (<1 parasite μL−1) in a label-free and real-time manner. The developed system would be of great potential for better diagnosis of malaria in low-resource settings.

Usefulness of automated hematology analyzer Sysmex XN 1000 in detection of Malaria

Objective: Malaria is a common parasitic disease present worldwide, especially tropical countries. It is challenging for most laboratories to provide a rapid and accurate diagnosis of malaria by light microscopy when the workload is high. The present study was undertaken to assess the usefulness of automated hematology analyzer Sysmex XN 1000 in the detection of malaria. Methodology: Sysmex XN 1000, a 6 part differential automated hematology analyzer was used to analyze EDTA anticoagulated samples of all febrile cases received from January 2014 to May 2014. Giemsa stained peripheral smears were also examined for malaria parasites. Abnormalities in WBC scattergrams were studied and their alteration in malaria cases recorded. Alterations in hematological parameters and instrument flags for samples positive for parasites were noted. All the samples were subjected to immunochromatographic assay by rapid test devises (RTD). Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by analysis of abnormal WBC scattergrams and by RTDs using immunochromatograpy were calculated. Results: A total of 940 samples were analysed. Out of these, 49 cases were positive for malaria on peripheral smear. Various abnormalities in the WBC scattergrams, hematological parameters of these samples and the instrument flags for these samples were noted. WBC scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26% for malaria diagnosis and RTDs using immunochromatographic assay showed a sensitivity of 90.91% and specificity of 98.92%. Conclusion: Malaria diagnosis by examination of Giemsa stained peripheral smears is still the gold standard for diagnosing malaria, which is a laborious process requiring highly skilled and experienced personnel. Complete blood count is a routine investigation ordered in any febrile case and analysis of scattergrams in such cases can definitely aid in detection of malaria.

The Validity of Rapid Malaria Test and Microscopy in Detecting Malaria in a Preelimination Region of Egypt.

Background. Malaria is a leading cause of morbidity and mortality worldwide. Rapid and accurate diagnosis of malaria would improve control measures and reduce morbidity and mortality. Objective. The aim of this study was to assess the prevalence of malaria in high risk foci in Egypt and the effectiveness of rapid diagnostic tests in diagnosis and subsequently control of malaria. Methodology. A total number of 600 cases of both sexes with different ages were included in the present study. Cases were included in 2 groups; first group (500 cases) were randomly selected from households in Fayoum Governorate and second group (100 cases) were admitted to Fayoum Fever Hospital with signs suggestive of malaria. Cases were subjected to detailed history taking, clinical examination, microscopic examination of thin and thick blood films, and immunological test to detect plasmodial antigens. Results. A total of 3 positive cases were detected by rapid diagnostic tests (RDTs). Out of these 3 cases, one case was positive for malaria parasite by microscopic examination of blood films. All positive cases in the study had history of travel to malaria endemic areas. Conclusion. RDTs are simple and effective for rapid diagnosis of malaria to help in implication of control measures in different localities.

Development of High Resolution Melting Analysis for the Diagnosis of Human Malaria.

Molecular detection has overcome limitations of microscopic examination by providing greater sensitivity and specificity in Plasmodium species detection. The objective of the present study was to develop a quantitative real-time polymerase chain reaction coupled with high-resolution melting (qRT-PCR-HRM) assay for rapid, accurate and simultaneous detection of all five human Plasmodium spp. A pair of primers targeted the 18S SSU rRNA gene of the Plasmodium spp. was designed for qRT-PCR-HRM assay development. Analytical sensitivity and specificity of the assay were evaluated. Samples collected from 229 malaria suspected patients recruited from Sabah, Malaysia were screened using the assay and results were compared with data obtained using PlasmoNexTM, a hexaplex PCR system. The qRT-PCR-HRM assay was able to detect and discriminate the five Plasmodium spp. with lowest detection limits of 1–100 copy numbers without nonspecific amplifications. The detection of Plasmodium spp. in clinical samples using this assay also achieved 100% concordance with that obtained using PlasmoNexTM. This indicated that the diagnostic sensitivity and specificity of this assay in Plasmodium spp. detection is comparable with those of PlasmoNexTM. The qRT-PCR-HRM assay is simple, produces results in two hours and enables high-throughput screening. Thus, it is an alternative method for rapid and accurate malaria diagnosis.

Assessment of the inter-rater reliability of the microscopic diagnosis of malaria in three Health Centres of Kayonza District, Eastern Province, Rwanda

Background: Globally, accurate diagnosis of malaria is essential for effective management of malaria and other frequently fatal non-malarial febrile illnesses that share the same signs and symptoms with malaria. Although malaria microscopic diagnosis using stained blood slides is considered to be a standard technique, it suffers subjectivity in its accuracy depending on the knowledge and skill of the technologist reading the slides. The purpose of this retrospective cross-sectional study done in 2013 was therefore to assess the reliability of microscopic diagnosis of malaria using stained blood slides by laboratory technologists in three Kayonza District health centres, Eastern Province, Rwanda. Methods: Forty archived stained blood slides of which 20 had been reported to be positive and 20 negative were selected from each of the three identified health centres by systematic sampling. Overall, 120 stained blood slides were collected and read by the Principal Investigator, and the quality control was done by the National Reference Laboratory.Results and conclusion The results of the diagnosis done by the health centre technologists and principal investigator agreed by 96.67% and was categorized as almost perfect according to the calculated Cohen’s kappa of 0.933, p&lt;0.001. Still, more trainings are recommended for the technologists.Key words: Microscopic Evaluation, Quality Control, Laboratory Technologist Malaria, Rwanda

Uncomplicated malaria in children: The place of rapid diagnostic test.

Background:Malaria has remained a major cause of morbidity and mortality among the under-five children in Nigeria. Prompt and accurate diagnosis of malaria is necessary in controlling this high burden and preventing unnecessary use of anti-malarial drugs. Malaria rapid diagnostic test (MRDT) offers the hope of achieving this goal. However, the performance of these kits among the most vulnerable age group to malaria is inadequate.Materials and Methods:In this cross-sectional study, 433 out-patients, aged <5 years with fever or history of fever were enrolled. Each candidate was tested for malaria parasitaemia using ACON; malaria pf. Thick and thin films were also prepared from the same finger prick blood for each candidate.Result:Malaria rapid diagnostic test had sensitivity of 8.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 74%. The sensitivity of MRDT increased with increasing age. This effect of age on sensitivity was statistically significant (P = 0.007). Similarly parasite density had significant effect on the sensitivity of MRDT (P = <0.001).Conclusion:Histidine-rich protein-2 based MRDT is not a reliable mean of diagnosing malaria in the under-five age children with acute uncomplicated malaria.

Assessment of competence of participants before and after 7-day intensive malaria microscopy training courses in Nigeria.

The accuracy of malaria diagnosis by microscopy has been a challenge in health facilities in Nigeria due to poor competence of microscopists and inability to report on malaria species other than Plasmodium falciparum. Short microscopy courses were conducted to improve the skills of laboratory personnel to perform malaria microscopy in public health facilities in Nigeria. Seven-day malaria microscopy courses were conducted annually between 2011 and 2013 for microscopists in public health facilities. The training courses contained theoretical and practical sessions. Impact of the training was evaluated by practical and theoretical pre- and post-training assessments on malaria slide reading, parasite enumeration and basic malariology. The 102 participants who completed the training consisted of medical laboratory scientists (62; 60.8%), medical laboratory technicians (24; 23.5%) and other healthcare workers (16; 15.7%). The knowledge of basic malariology (theory) at pre- and post-tests were 34% (95% CI 31.7-36.3%) and 74.9% (95% CI 71.8-78.0%), respectively (P<0.001). The mean slide reading detection, species and counting agreements in pre-training assessment were 48.9%, 27.9% and 0%, respectively, and in post-training 56.8%, 39.2% and 25%, respectively. The mean species agreements in picture test pre- and post-training were 21.9% and 55.1%, respectively. There were significant differences (P<0.05) in the median pre-test scores in picture tests and basic malariology of the three categories of participants but not in malaria slide reading and parasite counting tests. However, post-training, a significant difference in test scores of the three categories of participants was recorded only for basic malariology (P=0.0003). The 7-day malaria microscopy courses significantly increased the knowledge and microscopy skills of the trainees and were sufficient to bridge the significant difference in baseline microscopy skills of the different categories of trainees that participated in the training courses.

Performance of SO Bioline FK80 Test Kit in Diagnosis of Malaria at Adama Malaria Center, Southeast Oromia, Ethiopia

Background: The use of RDT (Rapid diagnostic tests) for malaria offers the potential to extend accurate malaria diagnosis to areas where microscopy services are not available. Objective: To evaluate the performance of SD FK80 test kit for the diagnosis of malaria and assess the trend of malaria transmission in Adama Malaria Center, southeast Ethiopia. Methods: A cross sectional study was conducted to evaluate the performance of SD FK80 kit for malaria (P.falciparum/P.vavix) diagnosis November to December 2012 at Adama Malaria Center, Southeastern Oromia. Three hundred eighty four blood samples were collected from febrile patients attending the outpatient department of Adama Malaria Center during the study period. The blood samples were analyzed with microscopy and RDT (SD Bioline P.falciparum /P.vivax) for the detection and identification of Plasmodium parasites. The data was entered into Microsoft® Excel and was transported to SPSS version 17.0 for statistical analysis. Sensitivity, specificity, positive and negative predictive values of the tests was calculated using microscopy as the reference standard. Result: Among the examined individuals, 107(27.9%) were found to be positive for plasmodium infection of which 23.7% were infected with P.vavix, and 3.9% were infected with P.falciparum while 0.3% were mixed infections The sensitivity, specificity, positive predictive value and negative predictive values of the SD Bioline were 90.7%, 96%, 89.8%, and 96.4%, respectively taking blood film as a gold standard. SD Bioline FK80 P.falciparum/P.vivax was performed satisfactorily for the diagnosis of P.falciparum and P.vivax infections. Conclusion: Based on our finding, Rapid test kit is satisfactory for diagnosis of P.falciparum and P.vivax infections. It is a useful adjunct to microscopy especially in our country where there is limited man power and resource.

An Enhanced Computer Vision Platform for Clinical Diagnosis of Malaria

Accurate malaria diagnosis is necessary to prevent unnecessary deaths and curb malaria drug resistance related to unnecessary treatment. While numerous diagnostic assays exist, the need for a low-cost, rapid and highly accurate malaria test remains. Here we evaluate the diagnostic performance of a computer vision platform, the Sight Diagnostic P2 device for malaria diagnosis, speciation and parasite quantification. The trial was conducted at two centers on Plasmodium falciparum and Plasmodium vivax samples, using different testing protocols: 374 samples were collected at City Hospital Mangalore India and 167 samples were collected at Lancet Laboratories Johannesburg South Africa. At City Hospital, the device diagnoses were compared to RT-PCR results while at Lancet Laboratories the device diagnoses were compared to a panel of tests provided by the clinic. For identification of malaria, the device demonstrated a sensitivity of 97% and a specificity of 99.5% at City Hospital India, and a sensitivity of 97.8% and a specificity of 97.5% at Lancet Laboratories Johannesburg. For speciation, the device correctly identified 87.5% for Plasmodium Vivax and 93.5% for Plasmodium Falciparum at City Hospital India. Lastly, comparing the device parasite count with that of trained microscopes, produced an average pearsons correlation of 0.87.

Lessons learned from the use of HRP-2 based rapid diagnostic test in community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

BackgroundRapid diagnostic tests (RDTs) are immune chromatographic tests targeting antigens of one or more Plasmodium species and offer the potential to extend accurate malaria diagnosis in endemic areas. In this study, the performance of Plasmodium falciparum-specific histidine-rich protein-2 (PfHRP-2) RDT in the detection of asymptomatic carriers from a hyperendemic region of Burkina Faso was compared with microscopy to gain further insight on its relevance in community-based interventions.MethodsThe performance of HRP-2 test was evaluated in terms of sensitivity, specificity, positive and negative predictive values, discordant values, likelihood ratios, accuracy, and precision using microscopy as the 'gold standard’. This analysis was carried out in a controlled, parallel, cluster-randomized (18 clusters; 1:1) study in children and adults. The effect of systematic treatment of P. falciparum asymptomatic carriers during three consecutive monthly community screening campaigns on the incidence of symptomatic malaria episodes over a 12-month period was compared with no treatment of asymptomatic carriers.ResultsSensitivity of HRP-2 test in asymptomatic carriers was higher in campaign 1 (92.4%) when compared to campaign 2 (84.0%) and campaign 3 (77.8%). The sensitivity of HRP-2 test increased as parasite density increased across all the age groups. Highest sensitivity (≥97.0%) was recorded at parasite densities of 1,000-4,999/μl, except for children aged 10 to 14 years. The specificity of HRP-2 test was comparable across age groups and highest in campaign 3 (95.9%). The negative predictive values were high across the three campaigns (≥92.7%) while the positive predictive values ranged from 23.2 to 73.8%. False-positive and false-negative rates were high in campaign 1 and campaign 3, respectively.ConclusionThe performance of HRP-2 test in detecting asymptomatic carriers of P. falciparum varied by age and parasite density. Although the use of HRP-2 test is beneficial for the diagnosis of acute malaria, its low sensitivity in screening asymptomatic carriers may limit its utility in pre-elimination interventional settings. The use of a practical and more sensitive test such as loop-mediated isothermal amplification in combination with a cost effective HRP-2 test may be worth exploring in such settings.

How well do malaria tests correlate with disease severity? Comparison of parasite density in children with mild and severe malaria.

Accurate diagnosis of malaria is key to proper management and control and an ideal diagnostic parameter that correlates to disease outcome is required. The former would be helpful in correctly identifying patients that need hospitalisation versus those that can be managed at home. This study determined how well the density estimates by microscopy, qPCR and PfHRP-2 correlate to malaria severity. Patients aged ≤ 5 yrs with severe (n = 60, Hb ≤ 6 g/dl) and mild (n = 60, Hb > 6 g/dl) malaria were enrolled to take part in a case control study at Kisumu District Hospital, Western Kenya. Parasite load was determined by microscopy, qPCR targeting the 18s rRNA gene and PfHRP-2 antigen ELISA. The median parasite load and the 25th and the 75th percentile by microscopy in children with severe malaria (SM) was 49,958 parasites/μl (12,013-128,695) compared to 24,233 (6,122-103,886) in the group with mild malaria (MM), P = 0.10. By qPCR, the translated median parasite density was 31,550 parasites/μl (4,106-196,640) in the SM group compared to 24,365 parasites/μl (5,512-93,401) in the MM group (P = 0.73). According to PfHRP-2, the translated median parasite load in children with SM was 628,775 parasites/μl (332,222-1.165x106) compared to 150,453 (94,292-399,100) in children with MM (P < 0.0001). Unlike microscopy and qPCR, the parasite load detected by PfHRP-2 correlates with disease severity. Because of its unique attributes, PfHRP-2 is able to account for trophozoites and schizonts that are sequestered away from peripheral circulation. Because it persists in circulation, it also serves as an indicator of the magnitude of current and recent infections.

Comparative study of modified quantitative buffy coat and two rapid tests in comparison with peripheral blood smear in malaria diagnosis in mumbai, India.

In order to identify a quick and reliable technique for accurate diagnosis of malaria, study of the efficiency of the tests such as Parahit total (HRPII & aldolase Ag), Advantage mal card (parasite specific LDH), and modified QBC was done in comparison with conventional blood smear microscopy. One hundred patients infected with P. vivax and 101 infected with P. falciparum were included in this study. The sensitivity of Parahit total, Advantage mal card, and modified QBC for P. falciparum detection was 70.3, 95%, and 98%, and specificity was 98%, 98%, and 96%, respectively. The sensitivity of Parahit total, Advantage mal card, and modified QBC for P. vivax detection was 73%, 97.0%, and 98%, respectively, and specificity of all the tests was 98%. On day 15, in falciparum arm, Advantage mal card and Parahit total showed 8 (7.92%) and 59 (58.41%) false positives. On day 15, in vivax arm, Parahit total revealed 52% false positives. The study indicated that modified QBC could be only used where appropriate facilities are available. Advantage mal card was a better follow-up tool than Parahit total.

Evaluation of two new rapid diagnostic tests (RDTs) for the diagnosis of malaria

Rapid diagnostic tests (RDTs) address the need for accurate diagnosis of malaria, particularly in resource limited settings. In this study, two malaria RDTs were compared with gold standard microscopy: On Site Pf/Pv test detecting Plasmodium falciparum-specific histidine rich protein-2 (Pf HR P2) and P. vivax-specific parasitic lactate dehydrogenase (pLDH) antigens; and SD Bioline anti-Pf/Pv test detecting anti-HR P2 and anti-pL DH antibodies for the diagnosis of P. falciparum and P. vivax infections, respectively. For OnSite test, the overall sensitivity was found 96.2% , specificity 98.2% , positive predictive value (PPV ) 98.2% , negative predictive value (NPV ) 96.4% and agreement with microscopy was found to be 0.94. On the other hand SD Bioline test, the overall sensitivity was 75.4%, specificity 83.7%, PPV 84.3% , NPV 74.5% and agreement with microscopy was 0.59. These data revealed that the R DT based on antigen detection (Onsite test) was more reliable than that based on the antibody detection (SD Bioline test).DOI: http://dx.doi.org/10.3329/bjmm.v5i2.16931 Bangladesh J Med Microbiol 2011; 05 (02): 11-15

Role of rapid diagnostic tests for guiding outpatient treatment of febrile illness in Liaquat University Hospital.

To assess the validity /strength of clinical diagnosis of Malaria on the basis of IMNCI algorithm by slide microscopy (gold standard) and to compare the effectiveness of Rapid Diagnostic Test (RDT )against slide microscopy. Methods : It is a descriptive cross sectional study of 6 month duration conducted at Pediatric Outpatient Department LUH Hyderabad from June-Dec. 2010. Sample of 400{the minimum required sample was 385 with malaria prevalence 5% (0.05) with margin of error of 3% (0.03, frequency vary from 2-8 % among different studies)} febrile children under 5 years classified as Suspected Clinical Malaria according to algorithm of IMNCI were included; The operational definition for Suspected Clinical Malaria was; fever for more than 2 days with no runny nose, no measel rash and no other cause of fever. Hyderabad was considered as low risk area. Rapid diagnostic test (RDT) and slide microscopy were done, and only confirmed cases were treated according to current guidelines given by National Malaria Program/updated IMNCI. Total 2000 patients under 5 years presented with fever and were evaluated. From 2000 cases 20% (400) were diagnosed as suspected clinical Malaria according to IMNCI algorithm; and only 40 cases (10%) have shown positive results for malaria parasite on slide microscopy and 38 cases on RDT. Regarding the plasmodium species 70% were vivax and 30% were falciparum. As regards the effectiveness, RDT has shown 95% sensitivity for the detection of plasmodium antigens in the febrile clinically suspected cases of malaria. Prompt and accurate diagnosis of malaria is needed for implementation of appropriate treatment to reduce unnecessary anti-malarial prescription. RDT is as effective as slide microscopy for the diagnosis of malaria especially in resource poor countries.

Plasmodium vivax aldolase-specific monoclonal antibodies and its application in clinical diagnosis of malaria infections in China

BackgroundMost rapid diagnostic tests (RDTs) currently used for malaria diagnosis cannot distinguish the various Plasmodium infections. The development of a Plasmodium vivax specific RDTs with high sensitivity to sufficiently differentiate the two most common Plasmodium infections would be very crucial for disease treatment and control.MethodPlasmodium vivax aldolase gene (PvALDO) was amplified from the extracted genomic DNA and constructed into pET30a vector. Plasmodium vivax aldolase protein was successfully expressed in Escherichia coli in soluble form and the overall purity was over 95% after one-step affinity chromatography purification. The purified products were used for the immunization of mice and rabbits. Rabbit polyclonal antibodies generated were deployed to develop a novel antibody-capture ELISA for hybridoma screening.ResultsThree PvALDO specific mAbs (14C7, 15F1 and 5H7) with high affinities were selected and used in immunochromatographic test strips. Clinical blood samples (n=190) collected from Yunnan (China) were used for evaluation and the RDT’s sensitivity for P. vivax was 98.33% (95% Confidence Interval (CI): 91.03% to 99.72%) compared with microscopic examination. There was specificity of 99.23% (95% CI: 95.77% to 99.87%) for P. vivax. Only one Plasmodium falciparum sample was detected among the P. falciparum samples (n=20). All Plasmodium malariae samples (n=2) as well as healthy uninfected samples (n=108) were negative. Overall performance of this RDT was excellent with positive predictive value (PPV) and negative predictive value (NPV) of 98.33% and 99.23%, respectively, at 95% CI and a very good correlation with microscopic observations (kappa value, K=0.9757). Test strips show high sensitivity even at 6.25 ng/ml of recombinant P. vivax aldolase (rPvALDO).ConclusionThis study further elucidates the possibility of developing aldolase-specific RDTs which can differentiate the different Plasmodium infections and improve accurate diagnosis of malaria. This RDT could adequately differentiate between P. vivax and P. falciparum infections. The novel mAb screening method developed here could find application in the screening of highly specific antibodies against other antigens.

FUZZY EXPERT SYSTEM FOR MALARIA DIAGNOSIS

Malaria remains one of the world’s most deadly infectious diseases and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces disease and prevents deaths. It also contributes to reducing malaria transmission. In recent times, Information Technology (IT) has played a significant role in the task of medical diagnosis. This paper work focused on Fuzzy Expert System for malaria diagnosis. It is simple to use, portable, low cost and makes malaria diagnosis more rapid and accurate. It supports medical practitioners and assists malaria researchers to deal with the vagueness, imprecision and time-consuming found in traditional laboratory diagnosis of malaria, and provide accurate output based on the input data.