Chapter 46 : Molecular Approaches for Diagnosis of Malaria and Characterization of Genetic Markers of Drug Resistance

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The diagnosis of imported malaria is complicated by the lack of experience with traditional microscopic detection methods and expertise with clinical malaria among laboratory professionals and clinicians, respectively. The development of powerful molecular techniques has led to extensive genetic and proteomic characterization of the malaria parasite. This chapter reviews the application of these molecular approaches for the improvement of malaria diagnosis and detection of genetic markers of antimalarial resistance. Real-time PCR assays for malaria diagnosis offer advantages in several of these respects. SNP analysis by mass spectrometry has been applied to the characterization and surveillance of various pathogens, including malaria parasites. Molecular methods not only are useful for detecting known resistance markers in parasite isolates but also may identify novel resistance markers. Another approach is based on the observation that drug resistance loci often have little sequence variation in surrounding genomic regions; these regions may not have yet been diversified by genetic drift if the resistance locus was recently acquired, or they may be essential for the resistance phenotype. The power of molecular technologies has led to improvements in the accuracy and rapidity of malaria diagnostic tests and detection of antimalarial resistance markers. Importantly, high-quality artemisinin combination treatments (ACTs) must be made accessible and affordable in regions where malaria is endemic, which will reduce demand for ineffective antimalarials and counterfeit drugs and preserve ACT efficacy.

Citation: Erdman L, Hawkes M, Kain K. 2011. Molecular Approaches for Diagnosis of Malaria and Characterization of Genetic Markers of Drug Resistance, p 691-711. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch46
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Generic image for table

Summary of molecular diagnostic modalities for malaria

Citation: Erdman L, Hawkes M, Kain K. 2011. Molecular Approaches for Diagnosis of Malaria and Characterization of Genetic Markers of Drug Resistance, p 691-711. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch46
Generic image for table

Summary of techniques for detection of genetic markers of antimalarial resistance

Citation: Erdman L, Hawkes M, Kain K. 2011. Molecular Approaches for Diagnosis of Malaria and Characterization of Genetic Markers of Drug Resistance, p 691-711. In Persing D, Tenover F, Tang Y, Nolte F, Hayden R, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555816834.ch46

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