Malaria diagnosis

P. falciparum can be identified using several methods which are used to diagnose malaria disease.

Microscopic examination of blood films

The most economic, preferred and reliable diagnostic method for malaria is microscopic examination of blood films. Thin or thick films stained with Giemsa allow a skilled microscope technician to identify parasites and have an idea of infection intensity - or parasitaemia.

New microscopy methods are being developed, with different staining techniques, for example a portable fluorescent microscope allows for a quicker but less reliable diagnosis. Fluorescence is incredibly useful for rapid identification of parasites, featured as bright green fluorescence in a black background.

Antigen tests

For faster diagnosis when microscopy is not available or laboratory staff are not experienced, there are now commercial antigen detection tests that require only a drop of blood. Malaria rapid diagnostic tests (RDTs) take 15–20 minutes to make a diagnosis. Unlike microscopy-based diagnosis, RDTs tend to be more expensive and harder to make available in rural areas.

Molecular methods

Molecular methods are available in some clinical laboratories. Based on the polymerase chain reaction (PCR), they are more accurate than microscopy. However, these methods are expensive and require a specialised laboratory.

Malaria treatments

Active malaria infection with P. falciparum requires hospitalisation so pathology can be minimised and parasitaemia contained using specific antimalarial drugs.
P. falciparum is able to develop resistance to most anti-malarial drugs, and for this reason the World Health Organisation now recommends the use of two or more drugs simultaneously. The latest most effective drugs are artemisinin combination therapies (ACTs). The primary compound - artemisinin - is combined with several others, such as mefloquine (ASMQ), lumefantrine (Coartem), amodiaquine (ASAQ), piperaquine (Duo-Cotecxin) and antifolates (Ariplus).

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