PLoS Med. 2011 Jan 25;8(1):e1000396. doi: 10.1371/journal.pmed.1000396.
Many of malaria's signs and symptoms are indistinguishable from those of other febrile diseases. Detection of the presence of Plasmodium parasites is essential, therefore, to guide case management. Improved diagnostic tools are required to enable targeted treatment of infected individuals. In addition, field-ready diagnostic tools for mass screening and surveillance that can detect asymptomatic infections of very low parasite densities are needed to monitor transmission reduction and ensure elimination. Antibody-based tests for infection and novel methods based on biomarkers need further development and validation, as do methods for the detection and treatment of Plasmodium vivax. Current rapid diagnostic tests targeting P. vivax are generally less effective than those targeting Plasmodium falciparum. Moreover, because current drugs for radical cure may cause serious side effects in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, more information is needed on the distribution of G6PD-deficiency variants as well as tests to identify at-risk individuals. Finally, in an environment of very low or absent malaria transmission, sustaining interest in elimination and maintaining resources will become increasingly important. Thus, research is required into the context in which malaria diagnostic tests are used, into diagnostics for other febrile diseases, and into the integration of these tests into health systems.
许多疟疾的症状和体征与其他发热性疾病难以区分。因此，检测疟原虫寄生虫的存在对于指导病例管理至关重要。需要改进诊断工具，以便对感染个体进行有针对性的治疗。此外，还需要用于大规模筛查和监测的现场准备好的诊断工具，以检测非常低寄生虫密度的无症状感染，从而监测传播减少并确保消除。需要进一步开发和验证针对感染的基于抗体的测试和基于生物标志物的新方法，以及针对间日疟原虫的检测和治疗方法。目前针对间日疟原虫的快速诊断测试通常不如针对恶性疟原虫的测试有效。此外，由于根治性药物可能会导致葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症患者出现严重副作用，因此需要更多关于 G6PD 缺乏症变异体分布以及识别高危个体的测试的信息。最后，在疟疾传播非常低或不存在的环境中，保持对消除的兴趣和维持资源将变得越来越重要。因此，需要研究疟疾诊断测试使用的背景、其他发热性疾病的诊断以及这些测试在卫生系统中的整合。
