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Malaria
Diagnostic Strategies
  1. To diagnose a case of unknown fever in individuals from an endemic area
    In holoendemic areas where most people have blood parasites and are asymptomatic carriers, it is difficult to prove the aetiology of a febrile episode. Higher densities of parasitaemia are correlated with a higher probability that the fever is due to malaria. Very often parasitological examination is not possible in the field.
     
  2. To diagnose malaria in a returning traveller
    This represents an urgent diagnosis and results should be available in a few hours. This can be achieved by either an experienced microscopist applying classical parasitological methods (thin and thick blood films) or a fast rt-PCR method to detect parasite DNA. Rapid diagnostic tests detecting parasite antigens have their limitations in sensitivity and species determination. They are an alternative if other methods are not available.
     
  3. To monitor control trials in an endemic area
    For this purpose, genotyping of malaria parasites has become an important method. It allows the differentiation of persisting strains from newly acquired ones in drug trials or allows one to detect a potential effect of vaccines on strain predominance.