Avila S L, Ferreira A W
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brasil.
Braz J Med Biol Res. 1996 Apr;29(4):431-43.
Malaria is the most prevalent endemic disease in large parts of the world and is subject to control by health authorities. Today, the goal of malaria control is to prevent mortality and reduce morbidity and socioeconomic losses through the progressive improvement and strengthening of local and national capabilities. The World Health Organization considers early diagnosis as the first basic element of the strategy to control the disease. Traditionally, laboratory diagnosis has been made using the thick blood film, which continues to be the gold standard test. However, this test has disadvantages such as the manner in which the film is prepared, the level of training of the observer, the adequacy of maintenance of materials and equipment and its only fair sensitivity. Thus, many research laboratories have concentrated their efforts on the development of alternative methods for malaria diagnosis. These include methods for the detection of Plasmodia within erythrocytes (fluorescent microscopy, Quantitative Buffy Coat (QBC), dark field microscopy, nucleic acid probes and immunofluorescence), methods for the detection of plasmodial antigens in body fluids (radioimmunoassay, enzyme immunoassay) and methods for the detection of anti-plasmodial antibodies in serum (indirect immunofluorescence, enzyme immunoassay, Western blotting). Here, we critically review the various methods for malaria diagnosis based on the world's literature and our experience with most of them, with emphasis on recent advances.
疟疾是世界上大部分地区最普遍的地方病，由卫生当局负责防控。如今，疟疾防控的目标是通过逐步提升和强化地方及国家防控能力来预防死亡、降低发病率以及减少社会经济损失。世界卫生组织将早期诊断视为控制该疾病战略的首要基本要素。传统上，实验室诊断采用厚血膜法，它仍是金标准检测方法。然而，该检测方法存在一些缺点，比如血膜制备方式、观察者的培训水平、材料与设备的维护状况以及其灵敏度仅为一般水平。因此，许多研究实验室致力于开发疟疾诊断的替代方法。这些方法包括检测红细胞内疟原虫的方法（荧光显微镜检查、定量血沉棕黄层法（QBC）、暗视野显微镜检查、核酸探针和免疫荧光法）、检测体液中疟原虫抗原的方法（放射免疫测定、酶免疫测定）以及检测血清中抗疟原虫抗体的方法（间接免疫荧光法、酶免疫测定、蛋白质印迹法）。在此，我们依据世界文献以及我们对其中大多数方法的经验，对各种疟疾诊断方法进行批判性综述，重点关注近期进展。
