Sensitivity and specificity of rapid biosensors for diagnosis of malaria in Kenya: Have they impacted the disease burden?

Malaria has over time constituted a significant public health threat across the world. The disease is caused by parasites of the genus Plasmodium. Currently, six species of the parasite have been implicated with causing malaria with Plasmodium falciparum bearing the greatest fatalities and burden. Globally, malaria cases are on the rise and with the emerging resistance to antimalarials, rapid and accurate diagnosis is of utmost importance. This review focuses on the specificity and sensitivity of different biosensors for malaria diagnosis using several surface modification strategies. Biosensors and immunosensors offer superior analytical performance compared to other malaria tests. They target specific proteins within the parasite and in doing so; not only detect the disease but also could indicate the stage of the parasite. These biomarkers include Plasmodium falciparum histidine-rich protein 2, parasite lactate dehydrogenase, aldolase, glutamate dehydrogenase, and biocrystal hemozoin. Overall, all specific biomarker-based immunosensors and biosensors are faster, low labor intensive, affordable, accurate, and reliable. However, the main problem associated with mass utilization is based on biomarker characteristics: PfHRP-2 has a longer duration in systemic circulation even if parasites are cleared, aldose-based biosensors have low sensitivity while some require complex architectural design for signal amplification. Due to such backdrops, biosensors and immunosensors remain the best diagnostic devices compared to other diagnostic tests such as RDTs. With proper design and precision, biosensors and immunosensors could offer promising prospects of accurate and reliable diagnosis of malaria. KEYWORDS: Plasmodium, Biosensors, Immunosensors, Malaria, PfHRP-2, pLDH, Aldose, Hemozoin