Gazing at the crystal rods of malaria.

Hemozoin, the black– brown crystalline byproduct from a parasite’s digestion of hemoglobin, aided the detection of malaria over a century ago when Ronald Ross won a Nobel Prize for his discovery of the transmission of malaria. Hemozoin was useful back then because little was understood of the parasite and hemozoin could be seen without a stain. For years the gold standard for diagnosing malaria has been simple microscopy that, while cheap, remains labor-intensive and requires significant training and experience. Rapid diagnostic tests have emerged for fast and easy use, but as Dr. David Sullivan of the John Hopkins Malaria Research Institute remarked in an interview to us, “There are disadvantages to tools on the market, or we wouldn’t be looking for new ones; if they were perfect, we’d stick just to them.” “The outdated idea that any febrile patient from a malaria endemic area should be treated with antimalarials has been replaced with the recommendation to test each patient with a rapid diagnostic test (when available),” explains Dr. Jeffrey D. Dvorin of the Division of Infectious Diseases at Boston Children’s Hospital. “Furthermore, a recent investigation of the etiology of fevers in a malaria endemic region of Tanzania demonstrated that malaria was not the cause of illness in the majority of patients. Although vaccine development and new antimalarial discovery remain important, accurate diagnostic tests that are field deployable (and cheap) are critical for malaria eradication,” he says. Available technologies may be limited in their ability to detect parasite levels below 200 parasites/ L of blood. In the quest for a more sensitive test and better tools to exploit its physical properties, hemozoin is seeing a resurgence in its diagnostic applications. One diagnostic approach, using magneto-optics, can operate on batteries and be manufactured at a low cost, giving it the potential for use in resource-poor areas where the problem of malaria is most profound. What Is the Innovation?