AUSTRALIA–INDONESIA JOINT SYMPOSIUM IN SCIENCE AND TECHNOLOGY
Jakarta, 13-17 September 2006
Malaria diagnosis in Indonesia: Facts and challenges
Dr Emiliana Tjitra, National Institute of Health Research and Development, Ministry of Health,
Jakarta, Indonesia
Diagnosis of malaria in Indonesia is still a problem. Clinical diagnosis is widely used for therapy because of limited access to qualify microscopy services. Malaria symptoms are non specific and usually overlap with other diseases. Therefore, malaria diagnosis based on clinical judgment alone is unreliable, and it should be confirmed by blood examination. To date the gold standard of malaria blood examination is microscopy of Giemsa-stained thick and thin smears. Other microscopy using fluorochromes, Quantitative Buffy Coat (QBC) is not suitable for field application and needs special and expensive equipments and supplies. Rapid Diagnostic Test (RDT) is based on the detection of antigen derived from malaria parasites in lysed blood using immunochromatographic method. There are number of marketed RDTs. These devices have been evaluated in the fields and consistently demonstrated acceptable sensitivities and specificities for detection P.falciparum, and it was still varied for detection P.vivax. However, RDTs will be very useful for early diagnosis and prompt treatment in emergency and remote areas. Polymerase Chain Reaction (PCR) is more sensitive and specific compare to other techniques. Though PCR required laboratory with special and costly equipments and supplies, PCR is needed for quality control of other diagnostic kits and in research. In conclusion, RDT is recommended as a complement for diagnosis of malaria in areas where there is no laboratory facilities.
