falciparum, will present after a longer period, that is, six months or more post-exposure. The large majority of travel-related malaria cases diagnosed in non-endemic countries present within several months of return from an endemic area Reference 3. Hence, clinical assessment, even by experts, cannot reliably confirm or exclude a diagnosis of malaria Reference 2. For example, fever is frequently not cyclic, and splenomegaly is rarely present early in the course of P. Although other signs and symptoms may be present in people with malaria, they are neither sensitive nor specific. It is the most urgent diagnosis to confirm or exclude in the febrile traveller who has been in a malaria-endemic zone. Plasmodium falciparum malaria can be rapidly fatal, particularly in a non-immune host. Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monographs or other similarly approved standards or instructions for use. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) or other similarly approved standards or instructions for use by the licensed manufacturer(s). Persons administering or using drugs, vaccines, or other products should also be aware of the contents of the product monograph(s) or other similarly approved standards or instructions for use. PHAC acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices, and is disseminating this document for information purposes to both travellers and the medical community caring for travellers. The Committee to Advise on Tropical Medicine and Travel (CATMAT) provides the Public Health Agency of Canada (PHAC) with ongoing and timely medical, scientific, and public health advice relating to tropical infectious disease and health risks associated with international travel. 6.2: Recommendations for malaria diagnostic testing.Table 6.1: Comparison of diagnostic tests for malaria.The RDTs that can be procured through the Global Fund to Fight AIDS, Tuberculosis and Malaria are listed on the World Health Organisation's list of prequalified in vitro diagnostics.An Advisory Committee Statement (ACS) from theĬommittee to Advise on Tropical Medicine and Travel (CATMAT) vivax in samples containing 200 parasites/µL. As a consequence, many RDTs might fail to detect P. vivax infections, lower expression of the specific antigen being detected for this species, and poorer performance of the reagents used for this specific antigen. 3 This is due to a combination of lower parasite density in P. falciparum, and uptake has been slow and inconsistent. vivax have relatively poor performance compared with those for P. vivax clinical cases.Īntibodies and antigens currently used for the detection of Plasmodium spp. vivax RDTs that do have significantly improved sensitivity – with the objective of reducing the number of missed P. falciparum, a number of initiatives are ongoing to develop P. 1 While the sensitivity of pLDH-detecting RDTs is often not as good as that achieved by HRP2-based RDTs for P. vivax is the parasite lactate dehydrogenase (pLDH). There the most suitable antigen for the species-specific detection of P. RDTs work by capturing dye-labelled antibodies bound to specific parasite antigens. They require no infrastructure or apparatus and can be used at the point-of-care, including in very remote areas. Regardless of the format, they are typically very simply to use, requiring no specialist services and minimal training. RTDs are available in various formats (dipstick, cassette or hybrids). These tests require a drop of peripheral blood, normally collected from a finger or heel prick. Visual read-outs are available typically within 20 mins or less. Malaria rapid diagnostic tests (RDTs) assist in the diagnosis of malaria by detecting evidence of malaria parasites (antigens) in human blood.
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