How well do the malaria rapid diagnostic tests for detecting the asymptomatic carriers in the endemic countries?

Article type
Authors
Naing C1
1International Medical University, Kuala Lumpur, Malaysia
Abstract
Background: Good-quality microscopy remains the standard laboratory method for the diagnosis of malaria. However, access to good-quality microscopic examination in endemic countries is limited, as resources are often lacking. The polymerase chain reaction (PCR) has also been established in the diagnosis of malaria. But, the expertise and the infrastructure required preclude its routine use in many health care settings. Rapid diagnostic tests for malaria (RDTs) detect parasite antigens in lysed blood from a finger-prick blood sample. This test is fast and easy to perform without special equipment or special skills. To date, systematic reviews of the accuracy of various RDTs in well controlled research settings using symptomatic patients in the endemic areas with either microscopy or PCR are available. People living in endemic areas often harbor Plasmodium parasites, but are asymptomatic. This asymptomatic state poses an important source of continuous malaria transmission within in the region. The accuracy of RDTs where people are primarily asymptomatic has not been assessed systematically. Hence, a research question arises: Whether RDTs are useful for detection of malaria in primarily asymptomatic people in the endemic countries? Objectives: To evaluate the accuracy of RDTs for detection of malaria in primarily asymptomatic people. Method: The method recommended in the Cochrane systematic review of diagnostic test accuracy is applied. The included studies identified for this meta-analysis compared the accuracy of RDTs with reference microscopy and/or PCR. The relevant study population is primarily asymptomatic people residing in endemic areas. Results: The diagnostic accuracy, and the risk of bias of studies identified for this analysis will be presented. Conclusions: The use of RDTs for rapid mass surveillance in malaria control so as to reduce the transmission and consequently the magnitude of malaria will be justified.