Exploring Biomarkers for Malaria: Advances in Early Detection and Asymptomatic Diagnosis

Malaria is a tropical disease caused by the Plasmodium parasite, which was responsible for 249 million cases worldwide in 2022. Malaria is currently diagnosed using RDTs, PCR-based methods, or blood smear microscopy. Ideal biomarkers have been identified for malaria, with the potential for improving treatment, diagnosis, and overall clinical outcomes. This review discusses the types of existing biomarkers and the opportunities for new biomarkers to be used as diagnostic components in detecting Plasmodium, including in terms of sensitivity, detection limit, specificity, and the species of Plasmodium that can be detected. Following a comparison, five main ideal malaria biomarkers were identified, namely HRP2, pLDH, hemozoin, aldolase, and pGDH. These biomarkers distinguished themselves markedly from the others in terms of specificity in Plasmodium detection, sensitivity in analysis, and the use of non-invasive samples. Several other biomarkers, such as CRP, Ang-1, Ang-2, and PCT, show potential for malaria detection in terms of their ability to differentiate disease severity, and the levels of these biomarkers can be determined in the body for comparison with malaria parasitemia. Of the five ideal biomarkers, hemozoin and aldolase can still be developed regarding the types of samples used and their sensitivity to different Plasmodium species. Further research on the biomarkers CRP, Ang-1, Ang-2, and PCT is still needed to evaluate their potential.