Diagnosis and Treatment of Malaria

Malaria is preventable and treatable. Early and accurate diagnosis followed by prompt treatment is essential to prevent progression of uncomplicated malaria to severe disease or death. There are different methods of detecting malaria parasites; one can either detect them visually under a microscope, with a rapid test that detects an antigen of the parasite, or via molecular diagnostics.

Broad Range of Application of Molecular Diagnostic Tools

Research groups at Swiss TPH and at our collaborating institutions in endemic areas have been using molecular diagnostic tools for many years in the frame of epidemiological studies. Many of the assays to detect and quantify all species of malaria parasites are equally useful for population based studies as for individual diagnostics at the Swiss TPH Travel Clinic where molecular tools complement microscopic examination of blood slides if high sensitivity is required or to support species differentiation.

Diagnostic Tools in Challenging Settings

Focus of current work is on development of novel diagnostic tools suitable for the use in resource limited settings. This aims at molecular assays for viral, bacterial and parasitic infections causing febrile diseases. Currently DNA and RNA amplification techniques are compared that are suitable for simple equipment that can be operated at the point of care. A Swiss National Science Foundation funded project has started in 2016 addressing the diagnostic needs in settings with declining malaria transmission and increasing prevalence of non-malaria fevers. Assays and treatment algorithms will be evaluated in the Amazonas region. Collaborators in Brazil are from the Instituto Nacional de Infectologia Evandro Chagas (Fiocruz).

From a public health perspective, diagnostic and treatment strategies implementation need to be monitored. Studies in health facilities are not easy and often biased due to several factors. Following the development of new methods for the measurement of nine antimalarial drugs in one go from dried blood spots, we are currently assessing the value of conducting surveys in the community to monitor antimalarial consumption and its relation with diagnostic testing and treatment, as well as with parasite resistance.