While microscopy and rapid diagnostics testing is helping to diagnose a huge number of cases of malaria, some slip through the diagnostic net. There are cases of malaria which are submicroscopic, meaning they are unidentifiable under a microscope.

A recently launched malaria test could hold the key to identifying the hidden threat. The test is much more sensitive than microscopy, more sensitive at detecting malaria parasites with conventional
rapid tests, potentially revolutionising malaria diagnosis. Using loop mediated isothermal amplification (LAMP) to identify the malaria parasite, the technology can produce results within an hour without the need for laboratory facilities. The ease with which the test can be used is of particular significance considering the greatest burden of malaria remains in regions where healthcare facilities are often few and far between.

For Professor Daouda Ndiaye, chief of the laboratory of parasitology and mycology at Cheikh Anta Diop University at UCAD CHU Le Dantec, who run the clinical studies on this new technology, this is not merely a scientific breakthrough, it’s a personal one. “My own commitment to the fight against malaria began as a child growing up in Senegal,” he recalls. “I survived severe malaria. My brother also contracted the disease. I was still at an early stage of my medical studies but, thankfully, I was able to recognise the symptoms and identify it so he could be treated.”

 

Advancements in research

 

Ndiaye has devoted his life to studying the disease and achieved his PhD at the Department of Immunology of Infectious Diseases at Harvard University, before returning to Senegal where he now leads the team working to control malaria and eliminate the disease. One of the problems Ndiaye noted was that benchmarks of success rely on malaria indicators like parasite prevalence. However, the traditional methods of diagnosis, such as microscopy and rapid diagnostic testing, lack the sensitivity to identify submicroscopic parasitemia.

As malaria can be transmitted from human to vector in pre-elimination settings, the sub-microscopic malaria is not just for the carrier but also for the community they live in. Adults with malaria may express low or delayed symptoms which might be transmitted to the youngest in the community. This ongoing threat of submicroscopic infection has justified the development of the newly launched LAMP molecular test.

“Faster and more accurate diagnosis is vital in the fight against malaria,” says Ndiaye. “Because of submicroscopic parasitemia carriage among the populations, a robust, sensitive and field community-deployable screening tool is needed to track the malaria reservoir in pre-elimination regions. The study we run in Senegal shows that tests such as Illumigene malaria have this capacity.”

Whilst sub-Saharan Africa continues to bear the greatest burden of malaria, as populations travel more, so malaria cases in Europe and the Middle East are also increasing. As a result, the new LAMP molecular test is good news for us all.