**Current Trends in Malaria Diagnosis**

158 Malaria Parasites

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**9** 

Adeola Orogade

*Nigeria* 

**Current Issues in Clinical** 

**and Laboratory Diagnosis in Malaria**

*Diagnosis is not the end, but the beginning of practice. ~Martin H. Fischer* 

Malaria is a protozoan infection (Najera &Hempel, 2006 as cited in Okwa & Ibidapo, 2010) with protean manifestations in the human species (Mohaptra, 2002; Murthy, 2000; Talib, 1996) causing nearly one million deaths mainly in African children and decreasing gross domestic product by as much as 1.3% in countries with high disease rates (World Health Organization [WHO], 2010). Approximately half of the world's population is at risk of malaria and in 2008; malaria was present in 108 countries and territories of the world (WHO, 2010). The most specific at risk population groups include young children in stable transmission areas, non immune pregnant women, semi immune pregnant women irrespective of HIV status, people with HIV/AIDS, international travelers to malaria endemic from non endemic areas as well as immigrants from endemic areas and their children living in non endemic areas returning to their home countries to visit friends and

Making a diagnosis requires careful clinical examination and laboratory investigation. Whereas malaria could be over diagnosed in endemic areas, (Ammah et al, 1999; Gwer et al, 2007; Hussain et al, 2009; Rehlis & Kurczewska, 2001; Rougemont et al, 2003; Smith et al, 1994;) in the non endemic areas a high index of suspicion is usually required (Berrang –Ford et al, 2008). However, in the most vulnerable: neonates, under fives, (Dzeing-Ella et al 2005) pregnant women, the elderly and non immune( Sengoz inan et al,2010) who may develop potential life threatening complications of *falciparum* malaria, it is important in most cases to make a rapid, accurate diagnosis to ensure prompt treatment. WHO recommends that before giving treatment, clinical malaria should be confirmed by parasite –based diagnosis. Treatment given solely on the basis of symptoms (presumptive diagnosis and treatment) should only be considered when a parasitological diagnosis is not possible. In 2008, 33 of 43 malaria endemic countries in the African region and 45 out of 63 countries in other regions were reported to have developed a policy of parasitological testing of suspected malaria cases in persons of all ages. However, policy development has not matched actual practice. Parasitological test for suspected malaria cases is carried out in less than 20% of individuals

living in 21 of the highest disease burden countries.(WHO, 2010).

**1. Introduction**

relatives (WHO, 2010).

*Ahmadu Bello University Teaching Hospital, Shika Zaria* 
