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Table 3 Strengths and limitations compared to the gold standard (microscopic examination of thick and thin blood films) of additional methods to diagnose malaria

From: Malaria diagnosis in a malaria non-endemic high-resource country: high variation of diagnostic strategy in clinical laboratories in the Netherlands

 

Microscopic examination of thick and thin blood films

ICT

LAMP assay

QBC examination

rtPCR

Sensitivity (detection limit)*

Reference method

− −

+ + +

 +  + 

+ + +

Plasmodium species determination

Reference method

− − −

− −

+ + +

P. falciparum determination

Reference method

±

− − −

+ + +

Parasitaemia determination

Reference method

− −

− − −

− −

Speed of examination

Reference method

+ + +

±

+ + +

− −

Simplicity of examination

Reference method

+ + +

+ +

− −

+

Low cost

Reference method

+ + +

Possible function in diagnostic strategy

All-round method that can be used as stand-alone method if experienced technicians are available

Fast and simple screening assay that can be organized close to the patient

Reliable exclusion of malaria by less experienced technicians

Fast screening for malaria parasites if experienced technicians are available

Slow confirmation assay in case other methods are non-conclusive

  1. ICT: immunochromatographic test; LAMP: loop mediated isothermal amplification; QBC: Quantitative Buffy Coat; rtPCR: real-time polymerase chain reaction
  2. *Based on an experienced laboratory technician; +, ± , −: better, equal or worse compared to the reference method microscopic examination of thick and thin blood films, respectively