**4. New enzymatic assay using parasite ldh in diagnosis of malaria in Kenya**

The biochemical basis for this assay is on the fact that human red blood cells do not utilize APAD in the metabolism of glucose. The study subjects were of three different categories: the healthy non-infected individuals staying out of malaria endemic area( controlled GP-1).The non-symptomatic and parasitemic healthy individuals living in endemic regions (both field study –GP 2).The non-parasitemic and parasitemic symptomatic individuals living in endemic region (both clinical study Group 3).In the clinical studies, thin smear microscopy gave the highest sensitivity as 75.6 % for plasma, while the highest specificity was 71.4 %. For red blood cells, the highest sensitivity was 78.4% while specificity was 80 %. In field trials, the highest sensitivity was 89 %) using thin smear microscopy, where as the specificity was 45% for the plasma cut off, using thick smear. For red blood cells, the highest sensitivity was 79% while the specificity was 66.7%. The variations in sensitivity and specificity of this assay in comparison to microscopy is a strong indication that pLDH may even be measuring sequestered parasites that cannot be visualized by microscopy. The results of the study validates the use of pLDH as an alternative objective test for malarial diagnosis against microscopy.
