Wambani Josephine, Okoth Patrick
KEMRI HIV Laboratory, Kenya Medical Research Institute KEMRI, P.O. Box 3-50400, Busia, Kenya.
Department of Medical Laboratory Sciences, School of Public Health, Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, P.O. Box 190, 50100 Kakamega, Kenya.
J Trop Med. 2022 Mar 22;2022:7324281. doi: 10.1155/2022/7324281. eCollection 2022.
Worldwide, transmission of emerging and reemerging malaria infections poses a significant threat to human health in the Sub-Saharan Africa, one that can quickly overwhelm public health resources. While the disease burden of malaria in the Sub-Saharan Africa appears to be on a gradual decline, it is characterized by spatial and temporal variability occasioning a sorry state for the Global South Countries. New evidence on long-term complications of malaria heightens our awareness of its public health impact. Given the likelihood of misdiagnosis, and the unknown levels of malaria transmission across different landscapes, many missed opportunities for prevention occur. Africa's population growth, unplanned urbanization, habitat destruction, and trans-border travel are contributing to a rise in the calamitous epidemiology of malaria. Despite empirical statistics demonstrating a downward trend in the malaria disease burden attributable to the scale-up of multiple control strategies, including new diagnostic technologies, malaria remains a global threat to human health in Sub-Sahara Africa. Malaria is a severe public health threat globally, despite several advancements and innovations in its control. Six species of the genus including and are known to infect humans. However, greatest disease burden and fatalities are caused by . Globally, about 3 billion individuals are at risk of contracting malaria disease every year, with over 400,000 fatalities reported in the Sub-Saharan Africa. World Health Organization (WHO) 2018 malaria report indicated that approximately 405,000 mortalities and 228 million cases were reported worldwide, with Africa carrying the highest disease burden. Over the last decade, there has been a significant decline in malaria deaths and infections, which may be related to the availability of effective diagnostic techniques. However, in certain areas, the rate of decline has slowed or even reversed the gains made so far. Accurate diagnosis, adequate treatment, and management of the disease are critical WHO-set goals of eliminating malaria by 2030. Microscopy, rapid diagnostic tests (RDTs), nucleic acid amplification tests (NAATs), and biosensors are all currently accessible diagnostic methods. These technologies have substantial flaws and triumphs that could stymie or accelerate malaria eradication efforts. The cost, ease, accessibility, and availability of skilled persons all influence the use of these technologies. These variables have a direct and indirect ramification on the entire management portfolio of patients. Despite the overall decline in the malaria disease burden driven partly by new diagnostic technologies, a sobering pattern marked by limited number of studies and spatial as well as temporal heterogeneity remains a concern. This review summarizes the principle, performance, gaps, accomplishments, and applicability of numerous malaria diagnostic techniques and their potential role in reducing the malaria disease burden in Sub-Saharan Africa.
在全球范围内,新兴和再现的疟疾感染传播对撒哈拉以南非洲地区的人类健康构成了重大威胁,这种威胁可能迅速耗尽公共卫生资源。虽然撒哈拉以南非洲地区的疟疾疾病负担似乎在逐渐下降,但其具有空间和时间上的变异性,这给全球南方国家带来了令人遗憾的状况。关于疟疾长期并发症的新证据提高了我们对其公共卫生影响的认识。鉴于存在误诊的可能性,以及不同地区疟疾传播水平不明,预防工作出现了许多错失的机会。非洲的人口增长、无计划的城市化、栖息地破坏和跨境旅行,都导致了疟疾灾难性流行病学的上升。尽管实证统计表明,由于扩大了包括新诊断技术在内的多种控制策略,疟疾疾病负担呈下降趋势,但疟疾仍然是撒哈拉以南非洲地区对人类健康的全球威胁。尽管在疟疾控制方面取得了一些进展和创新,但疟疾在全球范围内仍然是严重的公共卫生威胁。已知该属的六个物种,包括 和 ,会感染人类。然而,最大的疾病负担和死亡是由 造成的。在全球范围内,每年约有30亿人有感染疟疾的风险,撒哈拉以南非洲地区报告的死亡人数超过40万。世界卫生组织(WHO)2018年疟疾报告指出,全球报告了约40.5万例死亡和2.28亿例病例,非洲的疾病负担最高。在过去十年中,疟疾死亡和感染人数大幅下降,这可能与有效诊断技术的可用性有关。然而,在某些地区,下降速度已经放缓,甚至扭转了迄今取得的进展。准确诊断、充分治疗和管理该疾病是世卫组织设定的到2030年消除疟疾的关键目标。显微镜检查、快速诊断测试(RDT)、核酸扩增测试(NAAT)和生物传感器都是目前可用诊断方法。这些技术有重大缺陷和优势,可能阻碍或加速疟疾根除工作。成本、操作简便性、可及性以及专业人员的可用性都会影响这些技术的使用。这些变量对患者的整个管理组合有直接和间接的影响。尽管新诊断技术在一定程度上推动了疟疾疾病负担的总体下降,但研究数量有限以及空间和时间异质性所标志的严峻模式仍然令人担忧。本综述总结了多种疟疾诊断技术的原理、性能、差距、成就和适用性,以及它们在减轻撒哈拉以南非洲地区疟疾疾病负担方面的潜在作用。