The diagnostic landscape
Globally, there were an estimated 214 million malaria cases and 438,000 malaria deaths in 2014. About 3.2 billion people in 97 countries are at risk of the disease, but 90% of malaria deaths occur in young African children.
Rapid and accurate diagnosis is critical for effective malaria treatment, control and elimination. Diagnosis also plays a central role in combatting rising levels of anti-malarial resistance.
WHO recommends that all patients with suspected malaria have a quality-assured parasitological test – by microscopy or rapid diagnostic test (RDT) – to confirm diagnosis. However, access to testing is still far from universal.
In 2013, 197 million microscopy assessments were conducted and 319 million RDTs were sold, but UNITAID estimates global testing needs at over 1 billion annually. In general, while access to testing has been increasing in the public health-care sector, it remains minimal in the private sector in affected countries.
Gaps & challenges in malaria diagnostics
Despite the large number of rapid diagnostic tests (RDTs) on the market, there are ongoing challenges related to test quality, from manufacture to proper storage and use in remote tropical settings. In addition, few of the available RDTs can detect P. vivax infections, and none can directly detect hidden parasite reservoirs in the liver.
Inadequate surveillance and the lack of tests to support elimination are also major gaps. There is a need for tools that can detect asymptomatic infections in remote locations. As rates of drug-resistant malaria increase, so does the need for better surveillance systems for detecting and containing transmission.
In addition, consistent and accurate diagnosis of malaria during pregnancy requires more sensitive rapid tests that can then guide treatment.
Malaria is an acute febrile illness caused by Plasmodium parasites and transmitted by mosquito bites.
Plasmodium falciparum parasites cause the most deadly form of malaria, and if left untreated for more than 24 hours, it can result in severe illness and death. This form of malaria is the most common in sub-Saharan Africa, where it accounts for 75% of cases.
P. vivax is widely seen outside sub-Saharan Africa and causes a chronic form of malaria that can cause severe illness, though fewer deaths. It is difficult to treat because of dormant forms of the parasite that remain in the liver.
Read the WHO malaria factsheet to learn more about this disease.
Strategic approach & malaria strategy
FIND supports the elimination goals of the Global Malaria Action Plan and the World Health Organization.
FIND is committed to increasing access in even the remotest areas to high-quality malaria diagnostic tools that have the confidence of health workers and patients.
Since 2007, FIND’s malaria programme activities have evolved from developing and implementing quality assurance (QA) systems for rapid diagnostic tests (RDTs) to maximizing the impact of RDTs and collaborating in the creation of new and urgently needed tools.
Now, the focus is on the scale-up of innovative, high-quality diagnostic solutions to improve case management and accelerate malaria elimination. Priority areas, defined based on identification of acute needs, aim to:
- Improve detection and management of non-falciparum malaria
- Maximize impact of high-quality malaria tests
- Enable elimination through new tools for surveillance and response
- Guide global prioritization of diagnostic solutions for malaria
Across all FIND’s activities, collaborating with partners is essential. We work with academia, industry, national malaria control programmes, international organizations, implementation agencies and global procurement agencies to increase access to effective malaria diagnosis.