[Microbiological diagnosis of imported malaria]

Area of Science:

• Medical Diagnostics
• Parasitology
• Infectious Diseases

Background:

• Current malaria diagnosis relies on rapid antigen detection tests (RDT) and Giemsa-stained blood smears.
• Microscopy is crucial for Plasmodium visualization, but expert availability can be a limitation.

Purpose of the Study:

• To outline optimal strategies for malaria diagnosis using available methods.
• To emphasize the complementary roles of RDTs and microscopy.
• To guide the initiation of empirical treatment and further diagnostic steps.

Main Methods:

• Utilizing rapid antigen detection tests (RDT) for initial Plasmodium screening.
• Performing Giemsa-stained thin and thick blood smear microscopy.
• Employing Polymerase Chain Reaction (PCR) for confirmation and submicroscopic parasitemia detection.

Main Results:

• RDTs are valuable for immediate screening, especially when expert microscopists are unavailable.
• Microscopy should be performed in parallel with RDTs and is not replaced by them.
• Delayed diagnosis (over 3 hours) should not impede empirical treatment in high-probability cases.

Conclusions:

• Malaria diagnosis requires prompt action, combining RDTs and microscopy.
• Repeat testing and expert consultation are necessary for persistent suspicion.
• PCR serves as a valuable tool for confirming diagnoses and detecting asymptomatic infections.