Is qPCR always the most sensitive method for malaria diagnostic quality surveillance?

In many studies to evaluate the quality of malaria diagnosis, microscopy or rapid diagnostic tests (RDT) are compared to PCR. Depending on the method for sample collection and storage (whole blood or dried blood spot), volume of blood used for extraction, volume of DNA used as PCR template, and choice of PCR target (single vs. multi-copy gene), the limit of detection (LOD) of PCR might not exceed the LOD of expert microscopy or RDT. One should not assume that PCR always detects the highest number of infections.

Automated summary

In studies evaluating the quality of malaria diagnosis, microscopy or rapid diagnostic tests (RDT) are often compared to PCR. Depending on factors such as sample collection, storage methods, and choice of PCR target, the limit of detection (LOD) of PCR may not always exceed that of microscopy or RDT.