Comparison of Microscopic Accuracy, Rapid Diagnostic Test (RDT), Polymerase Chain Reaction (PCR), and Loop-Mediated Isothermal Amplification (LAMP) in Malaria Diagnosis: A Literature Review

Abstract : Malaria is an infectious disease that remains a global public health problem, especially in tropical and subtropical countries such as Indonesia. This disease is caused by the Plasmodium parasite, which is transmitted through the bite of infected female Anopheles mosquitoes. According to the 2024 World Malaria Report, there were approximately 249 million cases of malaria and 597,000 deaths worldwide, with Indonesia accounting for approximately 1.8 million cases or 46% of the total cases in Southeast Asia. This condition shows that malaria is still a major challenge in the national health system, especially in endemic areas such as Papua, Nusa Tenggara, and parts of Kalimantan. Rapid and accurate diagnosis of malaria is crucial in reducing morbidity and mortality rates. Peripheral blood microscopy is still considered the gold standard because it can identify Plasmodium species and assess the degree of parasitemia, but its sensitivity decreases in infections with low parasite density. Advances in diagnostic methods have led to the development of Rapid Diagnostic Tests (RDTs), which detect specific parasite antigens and provide rapid results, although the results can be affected by HRP2 gene mutations and reagent storage conditions. Furthermore, molecular methods such as Polymerase Chain Reaction (PCR) offer the highest sensitivity with the ability to detect up to 0.25–5 parasites/µL, but require advanced laboratory facilities. The latest innovation, Loop-Mediated Isothermal Amplification (LAMP), can amplify parasite DNA at a constant temperature of 60–65°C without a thermal cycler, with sensitivity and specificity reaching 95–99%. Therefore, this literature review highlights that a combination of conventional and molecular methods is essential to improve diagnostic accuracy and support malaria elimination efforts in Indonesia.