Malaria

Case management of malaria: Diagnosis

J Frean, B Poonsamy, B Shandukani, D Moonasar, J Raman

Abstract


Laboratory diagnosis of malaria in South Africa has traditionally relied on microscopic examination of stained blood films. More recently, rapid diagnostic tests (RDTs) have been introduced into routine use, and molecular methods like polymerase chain reaction are useful in certain situations. As with all laboratory tests, each technique has its advantages and disadvantages. Microscopy and RDTs, if appropriately quality assured, are adequate for clinical case management. For elimination, active surveillance will need to be expanded substantially, with wider use of more sensitive diagnostic nucleic acid amplification techniques, and/or serology. To facilitate surveillance activities, techniques suitable for field or near-field use would be ideal. A long-running external quality assessment programme in South Africa has shown some deficiencies in the quality of malaria diagnosis in routine laboratories. Quality systems across the spectrum of diagnostic facilities in South Africa need strengthening, to ensure progress towards elimination. 


Authors' affiliations

J Frean, Centre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Pathology, University of the Witwatersrand, Johannesburg, South Africa

B Poonsamy, Centre for Opportunistic, Tropical and Hospital Infections, National Institute for Communicable Diseases, Johannesburg, South Africa

B Shandukani, Malaria Directorate, National Department of Health, Pretoria, South Africa

D Moonasar, Malaria Directorate, National Department of Health, Pretoria, South Africa

J Raman, Malaria Research Unit, South African Medical Research Council, Durban, South Africa

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Keywords

epidemiology; malaria; case management; rapid diagnostic test; Malaria Control Programme

Cite this article

South African Medical Journal 2013;103(10):789-793. DOI:10.7196/SAMJ.7442

Article History

Date submitted: 2013-08-29
Date published: 2013-08-29

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