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

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

	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

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

ISSN: 1475-2875