BACKGROUND: There were no reports of any other species of Plasmodium except for P. vivax in Korea and the diagnosis of malaria has been made using microscopic examination of Giemsa-stained thick and thin blood films. This method is labor-intensive, time consuming and requires microscopic expertise. Therefore, the alternative techniques, rapid immunocapture assays, have been sought for use in the Korean Military. We performed an evaluation of the OptiMAL test to assess its sensitivity and treatment monitoring of Plasmodium vivax malaria. METHODS: We collected 77 whole blood in EDTA from 55 patients who were presented and diagnosed for P. vivax by microscopy of blood smears (thick and thin) at the Capital Armed Forces General Hospital (CAFGH) between May and October 2000. The OptiMAL test was performed according to the manufacturer's instructions on all samples. RESULTS: Compared with the blood film, the OptiMAL test identified 51 cases (83.6%) among 61 microscopy positive cases. Six cases were misinterpreted as Plasmodium falciparum. The diagnostic sensitivity of the OptiMAL test was 93.4% on 61 samples and 96.7% on 30 samples at a parasitemia level of more than 2,000/L parasites regardless of Plasmodium species. The discrepancy rate between the microscopy and the OptiMAL test is 38.1% in the samples from 21 patients at 2 or 3 days after treatment. CONCLUSIONS: Our data demonstrated that the OptiMAL test has limits and is not yet satisfactory to replace the conventional microscopy. However, regardless of the Plasmodium species the sensitivity of the OptiMAL test is relatively high and is comparable to that of microscopy in detecting malaria at the parasitemia level of more than 2,000/L parasites. It is an easy, rapid and useful tool in a field like the military.
Arm ; Diagnosis* ; Edetic Acid ; Hospitals, General ; Humans ; Korea ; Malaria ; Malaria, Vivax* ; Microscopy ; Military Personnel ; Parasitemia ; Parasites ; Plasmodium falciparum ; Plasmodium vivax* ; Plasmodium*