August 14, 2021

Closing the gap in Surveillance and Treatment in Malaria: The Diagnostic Approach

In India, P.vivax and P.falciparum cause the bulk of Malarial infections. While P.vivax is more in the plains, P.falcipraum is prominent more in the forest and peripheral regions. As a result, the central India region and North Eastern states have high transmission of Malaria compared to other areas. Rugged geographical terrain, regional conflicts, and inadequate health infrastructure are responsible for the increased incidence. In addition, lack of awareness is posing a challenge among tribes for reducing the transmission of disease.

India has registered a steady decline of Malaria cases of 24% from 2001-2018. As per WHO, India is the only country that has shown progress in reducing the global Malaria burden. Still, at large, ˜ 94% of its population are at risk of getting Malarial infection. According to World Malaria Report 2018, India will reduce its malaria cases by 20-40% by 2020. However, the Malaria Surveillance in the country is too weak in reporting. The surveillance system only said 8% of the cases. This is a bottleneck to achieve the goal of proper diagnosis and effective management. Poor access to endemic areas is one of the significant challenges to proper diagnosis and treatment. The government has now emphasized the use of whole blood antigen rapid kits and ELISA kits. Blood Smear Microscopy remains the standard gold test. It helps in reducing the erroneous diagnosis of the disease. However, even microscopy requires laboratory infrastructure, testing expertise and is also labor-intensive. Agglutination assay is a low-sensitive test rarely used these days.

The Govt. of India banned antibody detecting rapid tests in March 2018. The only antigen-based quick diagnostic kit is now used for screening Malaria. The antibody card kit was not practical for routine diagnosis of the acute form of the disease. There were discrepancies in the antibody titer between active infection and lag phase or recovery. Moreover, these cards only measured the past exposure but didn’t detect the current infection. It resulted in a high false-positive rate in endemic areas.

The priority method of diagnosis should be one that during the early stages of symptoms should detect severe Malarial and can lead to prompt emergency care of the patient. Rapid detection tests in the form of cards are the most convenient and used test for screening of Malaria. However, the confirmation could be done in the most accessible and affordable form with the use of ELISA tests.

J Mitra & Co. offers a wide range of diagnostic kits for the early diagnosis of Malaria. These kits range from Antigen cards to whole blood ELISA test kits. Finger prick detection is ideal for performing tests on antigen cards. The whole blood-based ELISA kit is user-friendly and cheap, and developed as per the latest guidelines of CDSCO only for blood banks. Blood banks are the major repository of donor blood and have outreach to a large population. The law mandates the screening of classified diseases for all the blood samples recorded in the blood bank. Hence it becomes essential to use the ELISA kit for efficient screening and maintaining a record of the samples. Also, it must be noted that the same can be used for candidates applying for immigration to other countries which have mandatory rules for Malaria Screening.

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