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A breath test that can detect malaria at an early stage is to be assessed in the real world in nations including Bangladesh, Malawi and Sudan.

The breathalyser could reduce the cost of testing for the parasite and ensure drugs are targeted more effectively in communities affected by the disease, its developers say.
Earlier they identified distinctive chemicals known as markers that can be detected in the breath of people with malaria.

“A field-based diagnostic tool that only detects active infection would be really useful in helping to detect asymptomatic individuals with low-level infection.”

Ailie Robinson, London School of Hygiene & Tropical Medicine 

The researchers from the Commonwealth Scientific and Industrial Research Organisation (CSIRO), an Australian federal government agency, will now spend the next 18 months assessing the test in the field. They will collaborate with colleagues in the United States after receiving a US$1.4 million grant from the Bill & Melinda Gates Foundation.

“We can now test the accuracy and effectiveness of the breath markers under real-world conditions,” Stephen Trowell, research group leader at CSIRO, said in a statement.

“If this phase of the research pans out, we intend to move on to developing a simple, painless and cheap breath test to help identify people who have malaria but don’t know it.”

CSIRO’s researchers will collect breath samples from patients suspected of having malaria. A control group will also provide samples for comparison before both sets of samples are sent to Australia or the United States for analysis.

The prototype device for collecting breath samples resembles the breathalysers police officers use to test motorists for drink driving. It is cheaper than conventional blood testing, requires no medical expertise to operate and could lead to early diagnosis, the developers point out.

“The detection of biomarkers in breath would certainly be an easier method for malaria diagnosis,” says Iveth González, who leads the Malaria & Acute Febrile Syndrome Programme at Swiss not-for-profit the Foundation for Innovative New Diagnostics. She adds that the devices could significantly help malaria control and elimination if their cost is low enough to compete with conventional testing, such as microscopy.

According to the World Health Organization, malaria can have severe and long-term consequences if not treated quickly. A recent WHO report said the goal of eradicating the disease in 35 target countries by 2030 was “achievable” but still a daunting challenge.

Ailie Robinson, a researcher at the London School of Hygiene & Tropical Medicine in the United Kingdom, says it will become increasingly difficult to detect malaria as it becomes rarer.

Current diagnostic methods also have limitations, she says. Some, such as microscopy, require technical expertise, while rapid diagnostics tests sometimes detect old infections.

“A field-based diagnostic tool that only detects active infection would be really useful in helping to detect asymptomatic individuals with low-level infection,” she says.

“Additionally, this technique would be totally non-invasive, which is clearly preferable — all current methods rely on a blood sample.” 


World malaria report 2015 (WHO, December 2015)