# Hemozoin as a Diagnostic Biomarker: A Scoping Review of Next-Generation Malaria Detection Technologies

## TL;DR

This review explores new malaria diagnostic technologies that target hemozoin, a biomarker produced by the malaria parasite, to improve detection accuracy and field applicability.

## Contribution

The paper provides a comprehensive scoping review of hemozoin-based diagnostic technologies and their current readiness for field use.

## Key findings

- Magneto-optical systems like Hz-MOD show high specificity but lower sensitivity at low parasite levels.
- Photoacoustic Cytophone enables noninvasive in vivo detection with promising sensitivity.
- Raman/SERS platforms offer high analytical sensitivity but are not yet suitable for field use.

## Abstract

Accurate malaria diagnosis is essential for effective case management and transmission control; however, the sensitivity, operational requirements, and field applicability of current conventional methods are limited. Hemozoin, an optically and magnetically active crystalline biomarker produced by Plasmodium species, offers a reagent-free target for next-generation diagnostics. This scoping review, following PRISMA-ScR and Joanna Briggs Institute guidance, synthesizes recent advances in hemozoin-based detection technologies and maps the current landscape. Twenty-four studies were reviewed, spanning eight major technology classes: magneto-optical platforms, magnetophoretic microdevices, photoacoustic detection, Raman/SERS spectroscopy, optical and hyperspectral imaging, NMR relaxometry, smartphone-based microscopy, and flow cytometry. Magneto-optical systems—including Hz-MOD, Gazelle™, and RMOD—demonstrated the highest operational readiness, with robust specificity but reduced sensitivity at low parasitemia. Photoacoustic Cytophone studies demonstrated promising sensitivity and noninvasive in vivo detection. Raman/SERS platforms achieved sub-100 infected cell/mL analytical sensitivity but remain laboratory-bound. Microfluidic and smartphone-based tools offer emerging, potentially low-cost alternatives. Across modalities, performance varied by parasite stage, with reduced detection of early ring forms. In conclusion, hemozoin-targeted diagnostics represent a rapidly evolving field with multiple viable translational pathways. While magneto-optical devices are closest to field deployment, further clinical validation, improved low-density detection, and standardized comparison across platforms are needed to support future adoption in malaria-endemic settings.