Malaria is caused by five species of parasite that affect humans, and all of these species belong to the genus Plasmodium: P. falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi. Of these, P. falciparum and P. vivax are the most important. Current MRDTs are based on detection of 3 different types of Plasmodium antigen. The first is Plasmodium Histidine Rich Protein-2 (pHRP-2), which can be specific to P. falciparum (PfHRP-2) or P. vivax.
The second is Plasmodium Lactate Dehydrogenase (pLDH), which can be specific to P. falciparum or P. vivax or be a variant that is common to all Plasmodium species (pan specific). The last is Plasmodium aldolase, which is pan specific. By combining detection of these 3 antigens on an Immune Chromatographic Strip (ICS) assay, MRDTs can detect any malaria species: P. falciparum alone, P. vivax alone or any combination thereof.
In tropical countries there are various other diseases mimicking as malarial fever eg. Dengue, leptospirosis, enteric fever;the positivity of MRDT aids in delineating the disease. Hence it limits treatment to patients who have malaria and no other febrile illnesses. The restricted use of effective anti-malarial treatment will decrease the consumption of unnecessary use of anti-malarial drugs and decrease the economic burden. Moreover it will prevent drug resistance where due to widespread empiric use of chloroquine-based therapy, it is no longer safe and effective. Artemisinin combination therapy are expensive drug and can be used judiciously in malarial patient and prevent drug resistance
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