Subject: tdr> Malaria Diagnosis - New Perspectives

A report summarizing the current status of malaria diagnostics and the
potential role of rapid diagnostic tests is now available on the TDR web
site.  A PDF version (462Kb) of the 57 page report "Malaria Diagnosis -
New Perspectives" in English can be accessed directly at

<http://www.who.int/tdr/publications/publications/malaria_diagnosis.htm>

or a printed copy can be ordered by email <[log in to unmask]>.

A description of the report follows: Sender: [log in to unmask]
Precedence: bulk

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Malaria Diagnosis - New Perspectives
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WHO/CDS/RBM/2000.14
WHO/MAL/2000.1091

Rapid diagnostic tests (RDTs) for malaria are now available that allow the
detection of Plasmodium-specific antigens in a finger-prick blood sample
in minutes, with sensitivity similar to that achieved by routine
microscopy. RDTs have introduced a new dimension to the diagnosis and
treatment of malaria. They permit, among other things, on-the-spot
confirmatory diagnosis of malaria at the periphery of the health care
system by health workers with minimal training. The rational use of RDTs
as a complement to microscopy might give substantial health benefits (a)
through earlier treatment and a consequent reduction in morbidity and
mortality, (b) by targeting expensive drugs and drug combinations to high
risk populations in multidrug resistant areas, and (c) through a more
rational use of drugs that might effectively reduce drug pressure and
might possibly delay the progress of drug resistance. Nevertheless, the
optimal role and conditions for the use of RDTs in relation to microscopy
remain to be determined.

In October 1999, TDR and Roll Back Malaria organized an informal
consultation, co-sponsored by USAID, to examine the role of new rapid
diagnostic tests in malaria control. The objectives of the meeting were:

- to define the rational use of microscopy and of RDTs for malaria
control;

- to identify factors that determine the choice of approaches to the
diagnosis of malaria;

- to define the desired specifications for new diagnostic tests; and

- to outline outstanding research questions and plan a research agenda.

This report outlines the discussions and outcomes of the consultation,
defining situations and regions of appropriate use for RDTs, and
highlighting the role of diagnostic confirmation in cost-effective disease
management and in reducing the unnecessary and irrational use of
antimalarial drugs. It includes a list of persisting issues that need to
be addressed through laboratory or field research, and a bibliography of
relevant publications in malaria diagnostics.