The role of a diagnostic reference laboratory in malaria surveillance

Abstract

Australia was declared free of malaria by the World Health Organization in 1981, but the infection has been endemic here in the past. Some tropical regions of the country are still considered to be receptive to its reintroduction. Although the risk of reintroduction is small, it cannot be dismissed. About 700-800 imported cases of malaria are notified in Australia each year. Most of these are imported from neighbouring countries such as Papua New Guinea and the Solomon Islands. A person who had arrived from the Solomon Islands was believed to be the source of a small outbreak of Plasmodium vivax at Cape Tribulation in north Queensland in 1986. There were at least four introduced cases and, almost certainly, one indigenous infection. The clustering of cases was detected because of the existence of a national surveillance system based on notified laboratory diagnoses. Without such a system, the relationship between a number of infections diagnosed in different parts of the country would almost certainly have gone unrecognised. Apart from supporting a surveillance system, reference laboratories can also provide a system of quality assurance for routine laboratories, many of which have difficulty in diagnosing infrequently seen infections such as malaria.