South African researchers to launch world’s first diagnostic saliva test for malaria

There were an estimated 435,000 deaths from malaria globally in 2017, with nearly 80 percent concentrated in 17 countries in the World Health Organisation (WHO) African Region and India. Nigeria (19 percent), Democratic Republic of the Congo (11 percent), Burkina Faso (6 percent), United Republic of Tanzania (5 percent), Sierra Leone (4 percent), Niger (4 percent) and India (4 percent) accounted for 53 percent of all global malaria deaths.

Prompt diagnosis and treatment is the most effective way to prevent a mild case of malaria from developing into severe disease and death. The world could fight malaria better if diagnosis is easier than it currently is. South Africa’s ERADA Technology Alliance Ltd (ERADA), pioneers of innovative, rapid diagnostic solutions for early detection of infectious diseases, have worked on this and will soon launch the world’s first diagnostic saliva test for malaria.

The saliva-based diagnostic tool, to be marketed by ERADA as a Saliva-based Malaria Asymptomatic and Asexual Rapid Test (SMAART) for subclinical infection, is set to transform malaria detection worldwide in the fight against one of the globe’s most deadly diseases.

The SMAART detection tool is the invention of leading, U.S based, researchers in the field of malaria diagnostics whose study was published on 2 January in the international journal, Science Translational Medicine.

ERADA’s innovative solution is easy- to-use, as it includes a simple device for standardized collection of saliva that can be implemented in the community by health care professionals, teachers and parents; contrasting with invasive blood tests, which must be administered by trained clinicians. Other drawbacks to blood tests include cultural ‘blood taboos’ existing in many countries whilst, furthermore, skin-prick tests are often stressful for children and parents.

Existing tests using blood may be invariably less reliable because subclinical infections with malaria-carrying parasites can be missed, leading some patients to come down with the disease, without knowing they have already been infected. ERADA’s SMAART-1, easy-to-use saliva test, leads to early detection, treatment and prevention of the disease as well as reducing further transmission of malaria. It detects a unique biomarker from female parasites circulating in an infected human who is asymptomatic, but is carrying the parasite and likely to come down with malaria within a week.

In some areas of the world, the parasites have acquired a mutation and are therefore no longer detected by current blood-based tests. But ERADA’s saliva test detects an essential protein the parasite needs for survival, which should avoid the problem of influence from the mutation and keep the test effective long-term.

Early, subclinical detection of malaria is crucial to malaria eradication because individuals who carry the parasite without exhibiting symptoms, known as carriers, are the reservoir that leads to infection of mosquitoes and transmission of the disease.

“As someone who has suffered from malaria, I know first-hand that if the parasite had been detected early, I could have been treated and cured before the symptoms of the disease made me unwell,” Dr Benji Pretorius, ERADA’s founder and Managing Director says.

“As a practicing clinician myself and following my personal experience of this debilitating disease, I was spurred on to work with my colleague Dr Richard Schmidt in our small community, Musina, in South Africa, together with a global team of scientists.”

“Our vision is to bring to market ERADA’s SMAART diagnostic tool as quickly as possible in the belief that it will go on to save literally millions of lives in the future.”

“The introduction of SMAART is going to play a major part in achieving effective diagnostic testing and surveillance; as well as prevention and treatment of this disease, and therefore will be a major catalyst in meeting the WHO’s 2030 target to reduce malaria incidence and mortality by 90% ,” Dr Pretorius says.

Research and development of the new saliva test was assisted with funding from the Bill & Melinda Gates Foundation.