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Malaria diagnosis: news and views |
Cahiers d'études et de recherches francophones / Santé . Volume 3, Number 4, 280-4, Juillet-Août 1993, Synthèse
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 Résumé
Article gratuit
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Author(s) : Pierre Ambroise-Thomas, Claudine Pinel, Hervé Pelloux, Stéphane Picot |
Summary : Diagnosis of malaria is mainly based on microscopic identification of Plasmodium in fixed and stained thin blood films.
In non-endemic countries, diagnosis of infection is synonymous with that of illness. Low levels of parasitemia, combined with insufficient competence of biologists for this specialized examination, can lead to late diagnosis with severe consequences. The situation is practically the opposite in endemic countries \; parasitemias are frequent but are only given attention when they reache sufficiently high levels to induce malaria. Identification of certain stages (gametocytes) is of particular importance to epidemiological studies. The recent development of a new analytical method (based on separation by centrifugation in capillary tubes followed by acridine-orange staining) holds out new possibilities. Although this method is prone to certain errors and cannot distinguish between Plasmodium species, it could be a valuable tool in non-endemic countries and for cases of low or non-existent parasitemia (diagnosis excluding malaria), especially for inexperienced biologists. Serology, given current techniques and reagents, is better suited to providing information on past and recent episodes of malaria, than on progressive disease \; interpretation is therefore often difficult. Recent studies suggest that identification of Plasmodium species with molecular probes will may be supplant in the future direct identification under the microscope as the principal means of diagnosis \; however, it cannot yet be predicted when such methods will become practical alternatives. Their sensitivity and accuracy would greatly improve diagnosis of malarial infections. It is equally likely that other biological tests under development will allow malaria to be distinguished from plasmodial infection in endemic zones. |
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