Malaria - DiagnosticTesting

        Malaria should be considered an emergency as it can be fatal if not treated appropriately in a timely manner. An individual may be suffering from severe malaria symptoms (e.g. confusion, coma, neurologic focal signs, severe anemia, and respiratory complications) or from first symptoms of malaria that are hard to distinguish from the usual presentation of flu and other viral infections. In places where malaria is not prevalent such as in the US, healthcare providers should be aware that they must test for malaria infection in patients who are experiencing symptoms listed. 

The first symptoms of malaria include the ff:
- fever
- chills
- sweats
- headaches
- muscle pains
- nausea and vomiting

        It may be challenging to detect malaria due to its common clinical presentation during its early stages. In order to rule out malaria, one needs to be examined for laboratory tests that would indicate whether one's RBC (i.e. red blood cell) is infected with malaria parasites. It should also include complete blood count workup initially and chemistry panel routinely.
What we mainly look at are the occurrences of the ff: 

- presence of malaria parasites in the blood

- presence of antigen from malaria parasites 

- presence of antibodies made by the body to fight off malaria infection

- severe anemia (i.e. low red blood cell count)

- hypoglycemia (i.e. low blood sugar levels)

- renal failure

- hyperbilirubinemia (i.e. high bilirubin levels in the blood related to the destruction of RBCs releasing hemoglobin that is further broken down into bilirubin)

- acid-base disturbances

        The WHO recommends to perform diagnostic tests first before treatment of any kind.

TEST. TREAT. TRACK approach to malaria treatment. 

        The two main ways to test for malaria include rapid diagnostic test (RDT) and microscopy. 

RDTs - tests for antigens produced by malaria parasites that are present in infected people. It is used because of convenience and due to less complicated way of performing and interpreting the test. RDT generally provides more rapid results that are useful in communities in which microscopy test services are not available. 

Microscopy - a way to test for malaria parasites by microscopically looking at blood smears. It allows identification and for us to determine which type of malaria parasites (e.g. P. falciparum, P. vivax, P. malariae, and P. ovale) is present in the bloodstream. This type of test is most common in hospitals and clinics. To ensure effective and specific microscopy test, there are a set of requirements to ensure quality management. Visit these sites to learn more: Quality assurance of microscopy-based diagnosis and CDC: Malaria - Diagnostic Testing.

Interesting watch about an innovative way to diagnose Malaria without pricking by Joshia Kavuma.

If you already know the background of malaria, listen about Joshia Kavuma's proposal in the video, click on 5:36. 

Bibliography:
Malaria Diagnosis (United States). (2012, November 9). Retrieved April 22, 2015, from http://www.cdc.gov/malaria/diagnosis_treatment/diagnosis.html

Rapid diagnostic tests. (2014, March 25). Retrieved April 22, 2015, from http://www.who.int/malaria/areas/diagnosis/rapid_diagnostic_tests/en/