Africa carries a disproportionately high share of the global malaria burden. Due to its presentation, malaria’s symptoms often mimic other diseases, and it is often under-diagnosed in areas where incidence is rare. Conversely, in endemic areas many people diagnosed with malaria may have the indicative parasite loads, but are in fact suffering from a different disease or condition. The presence of parasites doesn’t necessarily indicate disease and many people in high-transmission areas learn to tolerate parasitemia.
Current Gold standards have their own limitation. Microscopy is labor intensive and the detection threshold is limited to good quality blood films, highly trained microscopists & high powered microscopes. On the other hand, RDTs cannot provide a quantitative measure of parasitemia.