普通光学显微镜诊断疟疾的历史及其发展

疟疾是严重危害人类健康尤其是热带地区的重要传染病之一.在人类控制疟疾的过程中,普通光学显微镜由于其准确性高、相对低廉的费用及提供的大量信息发挥了极大作用,至今还广泛应用于诊断与科研中.但是由于显微镜检疟疾存在许多不足之处,如需要培训专门的镜检人员,镜检效率低,尤其是当血中疟原虫密度较低时其敏感性亦较低而倍受诟病.再加上近些年基于抗原抗体反应的各种快速诊断方法不断取得进展,使得现场显微镜诊断疟疾在未来有被取代的可能,或许光学显微镜对疟原虫的用途只保留在形态学研究中.

Retrospect of light microscopy diagnosis of malaria: a brief review

Malaria causes significant morbidity and mortality, the number of malaria cases is still noteworthy, and rampant drug resistant strains of parasites worldwide are increasingly focused on. Rational therapy of malaria is essential to avoid non-target effects, to delay the advent of drug resistance, and to save cost on alternative drugs. So it is of absolute necessity for effective and practical malaria diagnosis. Light microscopy diagnosis of malaria in fields has a history of more than one hundred years and been ever regarded as the "gold standard" due to its advantages. As one of the most important approaches it is still applied in most settings throughout the world. However, owing to its inherent drawbacks, such as labor intensive, time consuming,training requirement for healthcare workers, and relatively low sensitivity particularly at low parasitemia, its utilization is restricted in resource-poor regions. Fluorescence microscopy was ever introduced into diagnosis of malaria to overcome the faults of light microscopy but almost fell into disuse attributing to too many flaws. Nowadays, thanks to the advantages and almost conquer the drawbacks of light microscopy diagnosis, the rapid diagnostic tests (RDTs) have become the focus of the application and have been used more and more in regions of malaria managements. RDTs would hkely take the place of light microscopy in malaria diagnosis in the fields in future.