Rapid Diagnostic Tests In Rwanda Case Study

Malaria has been a major life-threatening disease for thousands of years, and continues to threaten millions of lives around the world. It infects approximately 219 million people each year, mostly poor women and children. What is striking about malaria is the fact that it has the worse effect on those with the least ability to fight the disease. The Republic of Cuba believes that malaria prevention, treatment, and research efforts must be accelerated to eliminate the burden of this disease across Africa, Asia, the Americas, and any country or territory at risk of malaria transmissions.

Brian, G, Y., Greenwood, D, A., Fidock, Dennis, E, K., Stefan, H, I. Kappe, P., Alonso, L., Frank, H and Collins, P (2008) “Malaria progress and prospects for eradication.” Journal Clinical Investiment. 118: 1266-1276.

Background - Malaria is a water borne disease. It is spread by a parasite-carrying mosquito. It kills many people and reduces a country 's capacity to develop. There are different strategies to combat malaria. Around half the population is at risk of malaria and this disease is active in 106 counties across Africa, Asian and the Americas (see source 3). the global annual mortality from malaria is between 1.5 - 3 million deaths, or between 4000 and 8000 each day. Developing countries are most vulnerable to Malaria and as shown on source 2 Malaria has been spread across many various other countries including in Europe, but these countries have eradicated Malaria.

The plasmodium parasite would be most susceptible to human antibodies between the moment of initial infection and the arrival of the larvae in the liver, as it travels through the bloodstream in the form of sporozytes. Here the parasite is fully exposed, not ensconced in liver cells or red blood cells as during later phases of its development. Though the lower numbers of parasites at this stage would trigger less of an antibody response, this lower plasmodium population would also be more effectively countered by the human body's natural defenses.

There have been many attempts at preventing malaria, none of which have been very successful. These have usually involved protecting human beings from mosquitoes, the dreaded carriers

Prompt and accurate diagnosis is critical to the effective management of malaria. The global impact of malaria has spurred interest in developing effective diagnostic strategies not only for resource-limited areas where malaria is a substantial burden on society, but also in developed countries, where malaria diagnostic expertise is often lacking [4,5]. Malaria diagnosis involves identifying malaria parasites or antigens/products in patient blood. Although this may seem simple, the diagnostic efficacy is subject to many factors. The different forms of the 5 malaria species; the different stages of erythrocytic schizogony, the endemicity of different species, the interrelation between levels of transmission, population movement, parasitemia,

Of the total 219 focal liver lesions biopsies, 206 biopsy specimens were sufficient for diagnosis (94.1%) and were insufficient in 13 biopsy specimens (5.9%). Nine biopsy specimens (69.2%) were only tissue necrosis and four specimens (30.8%) were too small tissue for definite diagnosis.

The biggest fish in the sea is a shark. It is called the whale shark and it is longer than two classrooms. A whale shark has many rows of small teeth. It eats only small fish. As a whale shark swims, it opens its mouth and swallows fish. It swallows enough water to fill a swimming pool when it eats. A whale shark lays big eggs. Whale shark eggs are as big as soccer balls. Whale shark eggs do not look like regular eggs. They are shaped like a rectangle.

It has been estimated that 609 million people in Africa are at risk of having malaria (Mabaso et al 2007, p. 35). Almost 34% of the populations in Zambia live in endemic risk areas, while 48% of the populations are in epidemic risk (Guerra et al., 2008, p.54; WHO

Clinical sensitivity of a method is how well a method will positively identify patients with a disease. A high sensitivity is essential in determining if a patient has a disease (Lalkhen & McCluskey, 2008, p.221). The clinical sensitivity of the microscopy method is 91% (Ohrt, Purnomo, Sutamihardja, Tang, & Kain, 2002, p. 540). However, the clinical sensitivity of the Qiagen artus® Real Art PCR is 99.5% (Farcas, Zhong, Mazzulli, & Kain, 2004, p.636). In conclusion of the two clinical sensitivities, the Qiagen artus® Real Art PCR method has a higher sensitivity in identifying patients with malaria. The lower limit of detection by a microscopy expert technician is 5 parasites/µl while an average technician is 50-100

The endothelial barrier becomes leaky allowing parasitic infection to commence. Other symptoms of Plasmodium falciparum parasitic infection are anemia. Because of the infection of red blood cells, anemia is highly likely once infected with the parasite. This is because of the lack of healthy red blood cells are circulating the human body. Examinations for a link between anemia and malaria have been conducted through the RSP2 surface protein. Through surface protein tagging, evidence has supported that the link occurs through sequestration, as larger amounts of red blood cells clump together (Layez et al., 2005). This unique molecular mechanism for destroying red blood cells was examined through the antibody response once anemia was witnessed. A chronic form of anemia can be observed. Anemia is common through the Plasmodium genus because all three species of Plasmodium infect red blood cells. Plasmodium falciparum not only can cause chronic anemia in most humans infected, but it can also be selective based on genes present in humans that can deter red blood cell infection. Another virulence factor to consider for this species is that of cytoadherence. During infection, this parasite releases adherence proteins, which incorporate themselves into the outer membrane of red blood cells. These proteins then attach to endothelial cell receptors in blood vessels preventing these infected cells from being cleared out by the spleen (Cholera et al., 2008). It is

Timely administration of appropriate antibiotics is essential for decreasing hospital mortality in patients with sepsis12. Kumar et al. demonstrated that with each hour delay, there is a 7.6% decrease in survival. Moreover, delaying appropriate antibiotics can increase healthcare costs, length of stay and antimicrobial resistance13, 14. Traditional methods of microbial identification have time concerns. Most laboratories take 48-72 hours to determine microorganisms’ susceptibility testing10, 15. Kerremans et al. did a prospective randomized controlled trial over two years period included 1489 patients to determine the utility of rapid diagnostic testing against traditional methods15. The intervention group had 20 hours mean reduction for

There is a need for diagnostic techniques like PCR with high sensitivity to provide accurate malaria diagnosis. With the active elimination of malaria infection, experts must conduct more case detections to identify one positive infection case (Bronzan, McMorrow & Kachur, 2008). The use of PCR may be limited because of its high cost per test (Cheng et al., 2015). Additionally, the use of active screening that is free of charge may encourage community-wide participation the (World Health Organization [WHO], 2012). The increase in massive screening is already straining the financial resources of many malaria control program. The need for technology advancement to produce screening methods with higher throughput at a lower cost and higher sensitivity is apparent. This work describes the development of Capture and Ligation Probe-PCR (CLIP-PCR) to meet these challenges. ). Reverse-transcription sensitivity PCR was achieved but got rid of its reliance to RNA reverse transcription and purification. Laboratory prepared samples used on a broad range of parasite pool sizes and densities before being applied to active screened dried blood spot samples gathered from 3 areas in China which are endemic. 18S rRNA of a genus Plasmodium is drawn from the blood and captured onto 96-well plates (Cheng et al., 2013). In addition to this, the 18S rRNA is measured by the amount of ligated probes that bind continually to it.

Analysis of investigations carried out in areas of different malaria endemicity have shown wide variation in the frequency and prevalence of these antibodies (Bousema and Drakeley 2011). Studies have demonstrated that while natural immunity does develop against sexual stages, little is known about age-dependent pattern of the antibodies. Age-dependency of the humoral response can be associated with repetitive exposure to the parasite (Graves, Wirtz et al. 1988,

Introduction: Worldwide emergence and spread of antimalarial resistance has led to use of molecular markers in monitoring of resistant plasmodium parasite. Single nucleotide polymorphisms in the K13 propellor domain have been recently associated with artemisinin resistance. This study aims at profiling K13 molecular markers related to reduced susceptibility to Artemether-Lumefantrine in parasite isolates from Msambweni coastal region, Kenya. Methods: Chelex method was used for extracting DNA from Plasmodium falciparum positive dried blood spots on filter paper samples. Polymerase chain reaction and sequencing technique was used to detect single nucleotide polymorphism in K13 propeller gene. MEGA 6 was used to identify specific SNP combinations using wild-type reference sequence (XM_001350122).