Rahi Manju, Sharma Rishu, Saroha Poonam, Chaturvedi Rini, Bharti Praveen K, Sharma Amit
Indian Council of Medical Research, New Delhi, India.
AcSIR, New Delhi, India.
Am J Trop Med Hyg. 2022 Feb 7;106(4):1005-1012. doi: 10.4269/ajtmh.21-0966. Print 2022 Apr 6.
Despite commendable progress in control of malaria in India and other countries, there are hidden reservoirs of parasites in human hosts that continually feed malaria transmission. Submicroscopic infections are a significant proportion in low-endemic settings like India, and these infections possess transmission potential. Hence, these reservoirs of infection add to the existing roadblocks for malaria elimination. It is crucial that this submerged burden of malaria is detected and treated to curtail further transmission. The currently used diagnostic tools, including the so-called "gold standard" microscopy, are incapable of detecting these submicroscopic infections and thus are suboptimal. It is an opportune time to usher in more sensitive molecular tools like polymerase chain reaction (PCR) for routine diagnosis at all levels of healthcare as an additional diagnostic tool in routine settings. PCR assays have been developed into user-friendly formats for field diagnostics and are near-point-of-collection. Because of the COVID-19 pandemic in India, these are being used rampantly across the country. The facilities created for COVID-19 diagnosis can easily be co-opted and harnessed for malaria diagnosis to augment surveillance by the inclusion of molecular techniques like PCR in the routine national malaria control program.
尽管印度和其他国家在疟疾控制方面取得了值得称赞的进展,但人类宿主中存在寄生虫的隐藏储存库,持续助长疟疾传播。在印度等低流行地区,亚显微感染占很大比例,且这些感染具有传播潜力。因此,这些感染储存库增加了消除疟疾的现有障碍。至关重要的是,要检测并治疗这种隐匿的疟疾负担,以减少进一步传播。目前使用的诊断工具,包括所谓的“金标准”显微镜检查,无法检测到这些亚显微感染,因此并不理想。现在是引入更灵敏的分子工具,如聚合酶链反应(PCR),作为各级医疗保健常规诊断的额外诊断工具的适当时机。PCR检测已发展成便于现场诊断的用户友好形式,且接近采集点。由于印度的新冠疫情,这些检测在全国被大量使用。为新冠诊断建立的设施可轻松用于疟疾诊断,通过将PCR等分子技术纳入国家常规疟疾控制项目来加强监测。