Diagnostic technique

Efficacy in Rural/Urban

Advantage

Limitation

Reference

WHO/CDC recommendation

Microscopy Giemsa or Acridine orange staining

Rural and urban settings

First line of standard diagnostics. Cost effective.

Less sensitive. Drug resistance not detected.

[8] [37] .

WHO recommends prompt diagnosis by microscopy or rapid diagnostic test (RDTs) [76] [77] .

Immunological test-RDTs

Rural and urban

Ease of use. Rapid results.

Less sensitive in low parasite count. False positive/negative. Drug resistance not detected.

[35] [40] [78] [79] .

WHO recommends prompt diagnosis by microscopy and commercial RDTs in endemic area [76] .

Serologic test-ELISA

Rural and urban

Rapid detection. More sensitive than microscopy.

False positive, less sensitive. Lab setting needed. RTDs are better evolved immunological technique for POC.

[38] [80]

Not recommended for regular diagnostics.

Immunofluorescence assay

Urban

High sensitive than microscopy.

Requires lab settings. Not cost effective. Time taking.

[39] .

Not recommended for regular diagnostics.

DNA based assay-PCR, RT PCR, Multiplex PCR/PCR-LDR, LDR-FMA, LAMP

Urban

High sensitivity and specificity. Drug resistance detection.

Standard lab settings required. Expertise needed. Not cost effective.

[43] [44] [45] [46] .

Not recommended for regular diagnostics. More useful in confirmation of parasite species and drug susceptibility.