Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings

Table 1 Summary of capacity for high-throughput and potential for field applicability of microscopy, RDT and novel nucleic acid amplification platforms

Diagnostic modality	Platform	Limit of detection (parasites/µL)	Number of samples processed (per assay or per day)	Validated on symptomatic or microscopy positive samples	Validated on asymptomatic or surveillance samples	Assay evaluated in resource-limited setting	Cost^a
Microscopy	Light microscopy [65]	50–499	15 min/slide^c	Yes	Yes	Yes	$
RDT	Immunochromatographic lateral flow assay^b [8]	200	15–20 min/test^d	Yes	Yes	Yes	$
PCR	Ultrasensitive qPCR [32]	0.022 (blood)	40 samples/day (manual) 140 samples/day (automated)	Yes	No	No	$$
	Multiplex Malaria Sample Ready [34]	0.244 (blood)	uncertain	Uncertain	Uncertain	Yes	$$
	Mobile PCR [35]	2 (DBS)	96 well plate, 240 samples/day	Uncertain	Yes	Yes	$$
	PET-PCR [37, 38]	3.2 (blood)	Real-time PCR platform, presumed 72 samples	Uncertain	Yes	No	?
	Gelcycler [39]	2 (blood)	12	Yes	Yes	No	$
	Multiplex microarray assay [40]	Uncertain	Uncertain	Yes	Uncertain	No	$$
	CLIP-PCR [42]	0.3 (DBS)	96 well plate + pooled DBS	Yes	Yes	No	$
LAMP	RealAmp [58]	0.4–40 (blood)	8 tubes	Yes	Yes	Yes	$$
	HtLAMP [57]	2.5 (blood)	96 well plate	Yes	No	Yes	$
	LAMP-LFD [60]	Uncertain	1.5 h/test	Yes	No	No	?
	NINA-LAMP [63]	Uncertain	5 tubes	Yes	Yes	Yes	?
	LoopAmp [51]	5 (blood)	16	Yes	Yes	Yes	?

DBS dried blood spot
^a$ < $US2; $$ > $US2, ? = cost unknown
^bMalaria Rapid Diagnostic Test Performance—results of WHO product testing of malaria RDTs Round 5 (2013)
^cWHO Malaria Microscopy Quality Assurance Manual Version 1, 2009
^dCDC website ww.cdc.gov/malaria/malaria_worldwide/reduction/dx_rdt.html

ISSN: 1475-2875