A rapid test using a mobile phone will be able to identify the most severe cases of imported malaria in minutes

Malaria remains the parasitic disease that causes the most deaths worldwide. Although it is not endemic in countries such as Spain, imported cases are diagnosed every year among people who return from areas where the infection is common. These patients can rapidly progress to severe forms of the disease, but identifying in time which cases are at higher risk is not always easy, especially in settings where clinical experience is limited and initial symptoms are nonspecific.

A recent study led by a research team from Rovira i Virgili University (URV) and the Barcelona Institute for Global Health (ISGlobal), an institution supported by the “la Caixa” Foundation, provides a new tool to address this challenge: a system that combines rapid diagnostic tests with video analysis using a mobile phone, capable not only of detecting the infection but also of predicting which patients may develop severe forms of malaria in under six minutes.

Key biomarkers for identifying severe malaria

The study, published in the journal Biosensors and Bioelectronics, focuses on the analysis of two biomarkers produced by the malaria parasite: the protein PfHRP2, specific to Plasmodium falciparum, the parasite that usually causes the most severe form of the disease, and the enzyme pan-lactate dehydrogenase (pan-pLDH), present in Plasmodium spp. Using laboratory immunoassays and lateral flow tests—similar to pregnancy tests or those used during the pandemic—the researchers compared the ability of both markers to diagnose malaria and to identify the most severe cases.

The results show that, although PfHRP2 is very accurate for confirming the infection, the pan-pLDH biomarker is particularly useful for distinguishing patients at risk of severe disease, even when used in simple rapid tests. “This difference is key from a clinical standpoint, as it allows relevant information to be obtained for decision-making without the need for complex laboratory equipment,” explains Claudio Parolo, Ramón y Cajal researcher in the Department of Chemical Engineering at URV and an external Associated Researcher at ISGlobal.

A strategy for non-endemic settings that could be transferable

This advance has so far been validated in non-endemic settings, where malaria is rare but potentially very severe, and where access to specialised diagnostic tools is often concentrated in reference centres. Nevertheless, the researchers believe the strategy could be transferable to endemic contexts in the future, as it is based on low-cost rapid tests and widely available technologies such as mobile phones. However, its performance will need to be validated in those settings, taking into account epidemiological and clinical differences.

The research was led by Claudio Parolo together with Daniel Camprubí, an ISGlobal researcher and physician in the International Health Service at Hospital Clínic Barcelona. The work was carried out as part of the doctoral thesis of Júlia Pedreira, a predoctoral researcher at ISGlobal, and also received support from the data science team coordinated by Paula Petrone, from the Barcelona Supercomputing Center, which contributed to supporting the quantitative analysis of the results.

The team is currently continuing to work on the validation of the results in larger sample sizes and in real clinical settings, with the aim that, in the near future, a simple rapid test analysed with a mobile phone could become a standard tool for the early assessment of imported malaria.

Reference

Julia Pedreira-Rincón, Leire Balerdi-Sarasola, Guillermo Villanueva, Pedro E. Fleitas, Alfons Jimenez, Alfredo Mayor, Jose Muñoz, Carme Subirà, Miriam J. Alvarez-Martinez, Paula Petrone, Daniel Camprubí-Ferrer, Claudio Parolo, pLDH to identify severity in imported malaria: Implementing smartphone video analysis for rapid clinical decision-making, Biosensors and Bioelectronics, Volume 294, 2026, 118228, ISSN 0956-5663, https://doi.org/10.1016/j.bios.2025.118228.