Pregnancy is a special time. And a special opportunity for malaria parasites.
Once bitten by an infected mosquito, a woman carrying a child is unlikely to experience malaria symptoms. The parasites make a bee-line for the placenta, rather than remaining in the blood, meaning the most common methods of identifying malaria infections—which rely on testing blood from a fingerprick—usually come up negative. In fact, there is evidence demonstrating that around 70% of malaria infections during pregnancy are missed by rapid diagnostic tests (RDTs) or microscopy.
So the parasites remain undetected, causing untold damage ranging from maternal anaemia to low birth weight—an important contributor to infant mortality. Dr Xavier Ding, Senior Scientific Officer here at FIND, is motivated by this challenge. “The devastation that families face when the health of their baby is compromised before the child is even born is deeply upsetting and unfair because it is, in theory, almost completely preventable,” he says. “What we need, more than anything else, are tests that are sensitive enough to detect parasites in pregnant women but still easy to use in very minimally resourced health facilities.”
A new diagnostic approach could be an answer for expectant mothers, and we are working with diagnostic manufacturers to develop new, highly sensitive tests. Several promising, innovative technologies have been developed and are being trialed. One is a rapid test that is ten times more sensitive than current RDTs when tested in the laboratory, created with Standard Diagnostics, supported by the Bill & Melinda Gates Foundation and PATH.
We are also excited to be partnering with the Papua New Guinea (PNG) Institute of Medical Research and the Burnet Institute, supported by the Australian government, to trial this new diagnostic in PNG. PNG is classified as a “low-transmission” country, where asymptomatic infections are common. The study will provide critical evidence about the performance of the new test and its capacity to improve detection—and therefore treatment—of malaria in pregnant women. If it is successful, the study could pave the way to policies recommending the use of such improved RDTs for the screening of pregnant women.