What Are The Tests For Diagnostic Precautions?

Accurate diagnosis of malaria is important because it helps to detect diseases early, select effective malaria drugs, and prevent severe disease progression leading to death. The clinical symptoms of malaria are not specific to this disease but may be encountered in many other diseases.
There are many subclinical techniques available to diagnose malaria from simple to complex; some can be done right next to a patient's bed, some require thoughtful equipment and people.
Detecting malaria through Giemsa-stained blood smear
Peripheral blood is drawn on the slide (thick drops and thin smears), Giemsa stained at a concentration of 3% - 5% and illuminated on an optical microscope with magnification of 700 - 1,000 times.
Thick drops are used to detect malaria parasites, thin spreads are used to identify parasites when in doubt

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A volume of 0.25 µl of blood must be examined before conclusions (about 100 microscope microscopic fields if an average has 20 leukocytes).
Microscopic examination of the blood smears has many advantages:
The technique is highly sensitive, and in practical terms the detection threshold is usually around 100 parasites / µl of blood
Answer the results including the parasite type, visible parasites, and the density of the parasites Parasite density is calculated by the plus sign (1+ - 4+, on the thick drop) or expressed as the number of kst / mául of blood.
Relatively less expensive.



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With the microscope can do other tests or can revive other health programs such as prevention of tuberculosis, helminths, sexually transmitted diseases ...
Blood samples may be stored for later review.
However, testing with a microscope has three main disadvantages:
Requires time and effort, often without immediate results
Need good microscopes, chemicals and standard techniques, well-trained and responsible testers
Because the results are not early, treatment is usually done before the test results are available if severe malaria is suspected.
Even so, the blood smear test is still considered the "gold standard" for diagnosing malaria, even if there are other techniques, because it can be done everywhere at a very low cost.
This method is also used to count the number of parasites in the blood to monitor the effectiveness of the drug (to count parasites based on leukocytes in the same microflora of thick drops, then deduce the number of parasites). organisms in blood µ µl).



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Alternatively, this method can be used to assess parasite density as the proportion of erythrocytes infected with parasites by thin smears.
Rapid Diagnostic Tests (RDT).
These are immunological tests to detect antigens of the malaria parasite. Note, do not use the parasite antibody detection test to diagnose malaria
Currently there are ca1cc types of rapid malaria diagnostic tests:
Test for the detection of HRP - II antigen (histidine rich protein II) secreted by immature and gametocytes of Plasmodium falciparum. This test only detected Plasmodium falciparum.
The antigen detection test is the pLDH enzyme (parasite lactate dehydrogenase) of four parasite species. and Plasmodium malariae). In practice, it is commonly understood to be used to detect Plasmodium falciparum and malaria caused by Plasmodium vivax.
Test to detect aldolase enzyme of malaria parasite.



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Often tests are presented in the form of a test strip, a cassette or a cardboard sheet and read the results within 15-20 minutes (depending on the manufacturer). This test can be performed by any health care provider after training very quickly
Note that the time of reading the results and the interpretation of the results should be observed in accordance with the manufacturer's instructions and take into account the test storage conditions (ambient temperature).
PCR method (polymerase chain reaction)
This is molecular biology technique, in which a gene segment of a parasite is multiplied millions of times and then is electrically run on gel and stained for detection.
The gene segment of the 18S rPNA and CS (circumsporozoite) subunits was used as the target to distinguish Plasmodium species.
The main advantage of PCR is the ability to detect parasites in patients with very low parasite densities (5 malaria parasites, PCR technique also helps distinguish the recurrence or re-infection of parasites. , or malaria drug-resistant parasites ...
This method is currently only available in a number of research institutes with modern equipment and adequate chemicals, but has not been widely applied.



For malaria parasites, the commonly used technique is nested PCR (CR cage) with two steps:
Step one, identify the: PCR copies the specific gene of the Plasmodium variety. The resulting product will be used for step two.
Second, identify species: PCR copies specific genes for each Plasmodium species with specific primers for each species.
The final product will be analyzed.

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