Malaria can be a severe, potentially fatal disease especially when caused by, and p. Microscopy plays a critical role in diagnosis of malaria, one of the major health problems in this area. In addition, a general pattern recognition framework to perform diagnosis, which includes image acquisition, preprocessing, segmentation, and pattern classification components, is described. If you clinically suspect a diagnosis of malaria, and the lab result of the malaria test is not available for more than. Therefore, the refresher training and qa programme should be systematically implemented together to improve parasitological diagnosis of malaria by microscopy. Cdc malaria malaria worldwide how can malaria cases. Evaluation of malaria microscopy diagnostic performance at private. The detection of plasmodium parasites by light microscopy is still the primary method of malaria diagnosis in most health care facilities throughout the world. Migrant workers clinic at mawker tai camp in thailand near the border with burma. In affluent countries, poor familiarity with malaria may cause clinical and laboratory misdiagnosis. Only plasmodium falciparum and plasmodium vivax infections were detected. Malaria microscopy quality assurance manual version 2.
Sep 17, 2018 in a study carried out in kenya, the diagnostic accuracy of malaria microscopy was positively associated with refresher training in microscopy. Education and information on diagnosis of malaria in the united states including microscopy, serology, rapid diagnostic testing rdt, and simian malaria. As useful as the use of microscopy in diagnosis may be, not all hospitals are. Despite the inherent limitations of giemsa microscopy for malaria, the quality of microscopic diagnosis largely depends on the quality of training. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. Learners guide isbn 978 92 4 154782 6 microscopists are vital to malaria programmes, and their diagnostic and technical skills are relied on in both curative services and disease surveillance. Malaria is a mosquitoborne infectious disease that affects humans and other animals. Therefore, the diagnosis of malaria needs to be highly specific and sensitive. Malaria is the most common single diagnosis made in many countries in africa. Light microscopy is the diagnostic standard against which other diagnostic methods have traditionally been compared. Performance of microscopy for the diagnosis of malaria and. Rdts and microscopy were carried out to diagnose malaria.
Competence also includes the ability of a microscopist to identify and correct problems in preparing, fixing or staining blood films. The absolute necessity for rational therapy in the face of rampant drug resistance places increasing importance on the accuracy of malaria diagnosis. Traditional microscopy for malaria definition traditional microscopy is an examination of a specimen of blood, usually capillary blood made in the form of a thick film and stained usually by giemsa stain, under highpower light microscope. The requirements of a diagnostic test are specificity, sensitivity, ease of performance and a reasonable cost. Greub 1 institute of microbiology, university hospital center and university of lausanne, lausanne. In severe cases it can cause yellow skin, seizures, coma, or death. Mostly, conventional microscopy is followed for diagnosis of malaria in developing countries, where pathologist visually inspects the stained slide under light microscope.
Laboratory diagnosis of malaria requires the identification of the parasite or its antigens products in the patients blood. In pakistan laboratory diagnosis of malaria is indispensable to avoid misdiagnosis as per national guidelines. The microscope is shown to be able to image below element 93 of a. Allows for faster diagnosis when microscopy not available. Computer vision for microscopy diagnosis of malaria malaria. Laboratory diagnosis of malaria conventional and rapid diagnostic methods michael l. Malaria diagnosis is performed by using rapid diagnostic tests rdts or by examining a blood smear under a microscope.
These include a malaria hotline, which provides access to cdc malaria experts, webbased, continuously updated information for clinicians on diagnosis and treatment of malaria, and diagnostic assistance through dpdx. Evaluating malaria prevalence using clinical diagnosis. Malaria is a curable disease if treatment is provided promptly and accurately. Results must be confirmed by microscopy not widely available in hospital or clinic labs limited information on species is given does not determine percent parasitemia unreliable in patient with recent history of malaria. Giemsastained thick blood film analysis is cheap and enables to score parasite density, to identify the different plasmodium species and to differentiate sexual gametocytes from asexual stages. Comparative diagnosis of malaria infections by microscopy. It can be used as an aid or a complete automated diagnosis technique, which replaces the manual microscopy examination. Performance of microscopy for the diagnosis of malaria and human african trypanosomiasis by diagnostic laboratories in the democratic republic of the congo. The learners guide basic malaria microscopy, part i will assist participants during training in the microscopic diagnosis of human malaria. Learners guide second edition basic malaria microscopy part 1.
Three methods, microscopy, nested polymerase chain reaction npcr, and loopmediated isothermal amplification lamp have been applied for malaria diagnosis in 105 human blood samples collected in northern thailand. Recent advances in the laboratory diagnosis of malaria btechan phd department of medical parasitology and entomology, faculty of medicine, national university of malaysia. Comparison of malaria rapid diagnostic test kit and. Malaria chapter 4 2020 yellow book travelers health cdc. Confirmatory diagnosis before treatment initiation recently regained attention, partly influenced by the spread of drug resistance and thus the requirement of more expensive drugs unaffordable to resourcepoor countries. During the malaria eradication me era, microscopy was the mainstay of malaria diagnosis. Aug 25, 2015 malaria remains a major global health burden and new methods for lowcost, highsensitivity, diagnosis are essential, particularly in remote areas with lowresource around the world. A malaria diagnostic tool based on computer vision. Basic malaria united states centers for disease control and. Various methods for malaria diagnosis are i peripheral smear examination by light microscopy.
Designed as the foundation for formal training of 45 weeks duration, the guide is destined for participants with only elementary knowledge of science. Diagnosis and treatment of malaria in india for malaria control, the main thrust of the national vector borne diseases control programme nvbdcp is on early diagnosis and prompt, complete and effective treatment. This manual is also to be used for training of personnel involved in diagnosis of malaria. Malaria is generally diagnosed by microscopy and rapid antigen testing.
In the laboratory, malaria is diagnosed using different techniques, e. Microscopy remains the gold standard for diagnosis of malaria 3. Results of a nationwide external quality assessment. Comparison of malaria rapid diagnostic test kit and microscopy. In a study carried out in kenya, the diagnostic accuracy of malaria microscopy was positively associated with refresher training in microscopy. Thick blood film samples a relatively large volume of blood thus allowing more efficient detection of parasites increased sensitivity. For all cases of suspected malaria, the healthcare provider should conduct an initial workup and arrange for a malaria parasitological test either via a quality assured rapid diagnostic tests rdt or a microscopic examination of blood smear slide either test, or both, can be used as a primary diagnostic tool for the. Giemsa is the classical stain used for malaria microscopy, and diagnosis requires examination of both thin and thick films from the same patient.
Cdc malaria malaria worldwide how can malaria cases and. The gold standard for the diagnosis of malaria involves microscopy with visualization of giemsastained parasites in a blood sample. Light microscopy entails visualization of the malaria parasites in a thick or thin smear of the patients blood. It is the mainstay of malaria diagnosis in most standard, well equipped health clinics and hospitals but the quality of microscopy based diagnosis is frequently inadequate 4. Microscopy method of diagnosis of malaria parasite involves the use of stained blood smears. For more than a century, use of microscopy has been considered the gold standard for malaria diagnosis, species. Research open access fluorescence microscope cyscope. The section on proficiency testing for malaria microscopy is based on work in the who regional office for africa in. Malaria diagnosis is carried out by microscopic examination of blood films collected by. However, microscopy requires welltrained, competent microscopists and rigorous maintenance of functional infrastructures plus effective quality control qc and quality assurance qa. The diagnosis of malaria in such countries largely depends on clinical assessment, microscopy and recently by rapid diagnostic tests rdts.
Giemsa microscopy and rapid diagnostic tests rdts represent the two diagnostics most likely to have the largest impact on malaria control today. Healthcare providers are encouraged to use cdc resources for malaria diagnosis and management advice. The direct microscopic visualization of the malarial parasite on the thick andor thin blood smears has been the gold standard for malaria diagnosis. In addition, a general pattern recognition framework to perform diagnosis. Pdf comparative study of malaria parasite diagnosis. There are several techniques use for diagnosis of malaria out of which includes the microscopy method, rapid diagnostic tests and molecular assay. Comparison of rapid diagnostic test plasmotec malaria3. Microscopy is considered the gold standard for diagnosis of malaria. Basic malaria united states centers for disease control.
Early, adequate diagnosis and prompt treatment is one of the main strategies in controlling malaria. Thick and thin blood smear for malaria diagnosis learn. Microscopy can provide immediate information about the presence of parasites, allow quantification of the density of the infection, and allow determination of the species of the malaria parasiteall of which are necessary for providing the most appropriate treatment. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. Existing works interpret the diagnosis problem differently or propose partial solutions to the problem. However, the microscope is a key tool in the integrated management of disease in resource poor settings, and the optimal role and conditions in malaria patients, a prompt and accurate diagnosis is the key to effec.
The principles and concepts of qa for microscope diagnosis of malaria are similar to those for. In order to assess the effectiveness of led fluorescence microscopy in malaria diagnosis, a crosssectional study was conducted at a tertiary care teaching hospital in mumbai. How ever, microscopy requires welltrained, competent microsco pists and rigorous maintenance of functional infrastructures plus effective quality control qc and quality assurance qa. Who recommends artemisininbased combination therapies acts, which contain an artemisininbased drug combined with another effective antimalarial, for the treatment of uncomplicated malaria. Comparison of three diagnostic methods microscopy, rdt, and. Basic malaria microscopy world health organization. To compare the two methods of rapid diagnostic tests rdts and microscopy in the diagnosis of malaria. Thick and thin blood smear for malaria diagnosis microbeonline. For precise malaria diagnosis, several diagnostic approaches are employed in labs including microscopy, immuneflorescence technique, immunechromatographic testing ict, pcr, and use of hematological analyzers 710. Overall, the measures of malaria diagnostic accuracy were high, i. Competence in microscopy is the ability of a microscopist to examine a malaria blood film accurately and report the results accurately. More recently, modern techniques utilizing antigen tests or polymerase chain reaction. Blood smear microscopy remains the most important method for malaria diagnosis.
Microscopy is the corner stone in malaria diagnosis. These two methods, each with characteristic strengths and limitations, together represent the best. In developing nations, scarce resources lead to inadequate diagnostic procedures. Microscopy is the gold standard for laboratory diagnosis of malaria parasite, but it requires adequate training and the time to get results is longer than that for rapid diagnostic tests rdts. The open problems are addressed and a perspective of the future work for realization of automated microscopy diagnosis of malaria is provided. However if there are conspicuous number of faint test bands, a. The document entitled, manual on quality assurance for laboratory diagnosis of malaria by microscopy describes step wise the minimum standards which must be followed for accurate and efficient diagnosis of malaria by microscopy. Introduction although serological methods are well. Microscopy requires a level of skill often not available in many health facilities in several malariaendemic countries, especially in remote rural areas, where most malaria transmission occurs.
Traditional malaria diagnosis historical strategies to diagnose malaria range from basic empirical clinical diagnostic algorithms to examination of stained blood smears by light microscopy. A rapid and accurate diagnosis of malaria is demanded for proper treatment on time. Thus, training in malaria microscopy must be sound. Comparison of microscopy and pcr for the detection of human. Malaria chapter 4 2020 yellow book travelers health. However, in diagnosing asymptomatic plasmodium parasitaemia among donors, the preferred technique should not only be timely but must not compromise diagnosis. Pdf diagnosis of malaria among blood donors in port. Malaria is a major world health issue and its continued burden is due, in part, to difficulties in the diagnosis of the illness.
Computer vision for microscopy diagnosis of malaria. Few real changes in the microscopy of malaria parasites have occurred since 1991, but much has changed in the way malaria is diagnosed and treated. Malaria is a lifethreatening disease caused by parasite of genus plasmodium, which is transmitted through the bite of infected anopheles. Although blood is the sample most frequently used to make a diagnosis, both saliva and urine have been investigated as alternative, less invasive specimens. Who recommends prompt parasitebased diagnosis by microscopy or malaria rapid diagnostic test rdt in all patients suspected of malaria before antimalarial treatment is administered.
Malaria, diagnosis, serology, monoclonal antibodies, dna probes. A crosssectional randomized study was conducted to evaluate the validity of clinical malaria diagnosis through comparison with microscopy and rapid diagnostic test kits rdts using consenting outpatients of a tertiary hospital in nigeria. Comparison of three diagnostic methods microscopy, rdt. The global control of malaria is more challenging than that of many other infectious diseases.
Multiplex realtime pcr for the diagnosis of malaria. Giemsa microscopy and rapid diagnostic tests rdts represent the two diagnostics most likely to have the. Malaria diagnosis using a mobile phone polarized microscope. Affordability, lowthreshold sensitivity, identification of species, and parasite density gives it. Even though microscopy is currently the standard method of malaria diagnosis it has the disadvantages of poor sensitivity and specificity, especially during low parasitemia. In the present study, the contribution of a quantitative multiplex malaria pcr was investigated. Malaria diagnostic platform, microscopy springerlink. In nigeria, malaria accounts for over 60% outpatient visits and 30% hospital admissions 6. Computerized diagnosis of malaria is a microscopy diagnosis technique by the use of computer vision and machine learning methods. Such malpractice is not limited to treatment of falsely positive malaria, but presumptive treatment is also frequently practiced 10,11. However, the microscope is a key tool in the integrated management of disease in resource poor settings, and the optimal role and conditions in malaria patients, a prompt and accurate diagnosis is the key. Current available techniques can be separated in three categories. The mainstay of malaria diagnosis has been the microscopic examination of blood, utilizing blood films. Image contributed by the shoklo malaria research unit external, mae sot, thailand.
The two most common techniques available for diagnosis of malaria in nigeria are microscopy and rapid diagnostic tests rdts. Microscopy is the gold standard for diagnosis of malaria, however, manual evaluation of blood films is highly dependent on skilled personnel in a. Endemic malaria, population movements, and foreign travel all contribute to the malaria diagnostic problems faced by the laboratory that may not have appropriate microscopy expertise available. Rapid diagnosis and prompt effective treatment are essential patients who reside in or have traveled to southeast asia receive intensive management as appropriate for severe falciparum malaria clin infect dis. Oct 19, 2009 malaria is a curable disease if treatment is provided promptly and accurately. Although empirical clinical diagnosis remains the most common method to diagnose malaria in many regions, the accuracy of this strategy is.
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