Evaluation of Point-of-care kit for Diagnosis of Malaria in Korea

Sun, Young Kyu; Kim, Young Ah; Lim, Hwan Sub

Abstract

BACKGROUND
Recently malaria infection became one of the most important parasitic diseases in Korea. After the re-emergence of malaria in a young soldier in 1993 near the De-Militarized Zone (DMZ), three to four thousand people have been infected per year in the last few years and the cases of infection have been increasing threefold each year. Microscopic examination of a thick blood smear is a conventional and confirmatory method for diagnosis. However, it requires labor-intensive procedures and its interpretation is quite subjective. Faster and more reliable methods are needed for the diagnosis of malaria.
METHODS
We evaluated 155 patients who were diagnosed as malaria. We performed point-of-care rapid diagnostic methods recently introduced: two antibody detection tests manufactured by Korean companies and one antigen (Plasmodium lactate dehydrogenase, pLDH) detection test. The results were compared with those of microscopic examinations of thick blood smears.
RESULTS
Sensitivities of two antibody detection assays and one antigen detection assay in acute attacks of malaria were 64.7%, 72.5%, and 96.1%; and, specificities were 88.5%, 89.4%, and 95.1%, respectively. Overall accuracy for all samples were 80.6%, 83.9%, and 95.5%, respectively.
CONCLUSIONS
Antibody detection tests for malaria have limitations in sensitivity and accuracy to replace microscopic examination of blood film. Antigen tests detecting pLDH could replace conventional microscopic examinations of blood film, especially in emergency situations in cases that require prompt medication.