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A new rapid diagnostic test could help protect the health of unborn babies

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Pregnancy is a special time. And a special opportunity for malaria parasites.

Once bitten by an infected mosquito, a woman carrying a child is unlikely to experience malaria symptoms. The parasites make a bee-line for the placenta, rather than remaining in the blood, meaning the most common methods of identifying malaria infections—which rely on testing blood from a fingerprick—usually come up negative. In fact, there is evidence demonstrating that around 70% of malaria infections during pregnancy are missed by rapid diagnostic tests (RDTs) and assessment of blood samples by microscope.

scientist looking into a microscope
Pregnant women with malaria often have a low density of parasites in their blood, meaning standard methods of diagnosis, like identification of parasites through a microscope, can often fail to spot infections. Photo credit: John Rae/FIND

So the parasites remain undetected, causing untold damage ranging from maternal anaemia to low birth weight—an important contributor to infant mortality. Dr Xavier Ding, Senior Scientific Officer at the Foundation for Innovative New Diagnostics (FIND), has been transfixed by this challenge. “The devastation that families face when the health of their baby is compromised before it is even born is deeply upsetting and unfair because it is, in theory, almost completely preventable,” said Dr Ding. “What we need, more than anything else, are tests that are sensitive enough to detect parasites in pregnant women but still easy to use in very minimally resourced health facilities.”

scientist at work
A photo taken by Dr Xavier Ding during a laboratory training he led in Indonesia in 2015 as part of a clinical trial of a new malaria test. Photo credit: X. Ding/FIND

A new diagnostic approach could be an answer for expectant mothers. Dr Ding and his colleagues at FIND have been working with diagnostic manufacturers to develop new, highly sensitive tests. Several promising, innovative technologies have been developed and are in the process of being trialed. One is a rapid test that was created with Standard Diagnostics, with the support of the Bill & Melinda Gates Foundation and PATH, which is ten times more sensitive than current RDTs when tested in the laboratory.

hands holding a testing kit
The highly sensitive rapid diagnostic test for malaria that will be trialed in Papua New Guinea is pictured here in a similar trial in pregnant women led by Dr Ding in Quibdo and Medellin, Colombia in 2017. Photo credit: A. Campilo /FIND

Dr Ding is excited to be partnering with the Papua New Guinea (PNG) Institute of Medical Research and the Burnet Institute, supported by the Australian government, to trial this new diagnostic in PNG. PNG is classified as a “low-transmission” country, where asymptomatic infections are common. The study will provide critical evidence about the performance of the new test and its capacity to improve detection—and therefore treatment—of malaria in pregnant women. If it is successful, the study could pave the way to policies recommending the use of such improved RDTs for the screening of pregnant women.