Rapid tests for malaria

Appropriate use

Rapid diagnostic tests (RDTs) for malaria offer a unique opportunity to expand access to accurate diagnosis to primary health care centers with out the requirement for laboratory facilities. Potential uses identified by the WHO’s Roll Back Malaria program include:

  • Diagnosis by health workers distant from good microscopy services
  • Remote diagnosis in organized workforces in malaria-endemic areas (e.g., the military or mining companies)
  • Outbreak investigation and malaria prevalence surveys
  • Self diagnosis by trained individuals or groups
  • “After hours” diagnosis in hospital laboratories or clinics

Malaria RDTs also would be a valuable resource for diagnosis of malaria in travelers and military personnel presenting to medical providers unfamiliar with malaria clinical diagnosis.

RDTs can be utilized for monitoring response to treatment with antimalarial drugs. However, the persistence of antigens in blood after clearance of infection should be taken into account when RDTs are used for this purpose. The antigen histidin-rich Protein 2 (HRP2) remains in the bloodstream for several days after parasites have been cleared, whereas the antigen pLDH has a shorter lifetime in the blood stream and may be a better indicator of infection clearance.

The proper introduction of rapid malaria diagnostics into malaria control programs is critical in an era of increased multi-drug resistant malaria and strained resources. Rapid diagnostic tests offer distinct advantages provided that test results are linked to proper treatment choices, the tests are used and stored correctly, quality control measures are installed, and they are affordable. Test performance is hindered by exposure to high temperature and moisture, so storage and transport systems must be developed to ensure tests remain as cool and dry as possible. In order for a malaria control program to be successful, context-specific factors (such as local transmission characteristics) must be taken into consideration when implementing RDTs. Please visit our page “Best Practices for RDT Introduction and Use” for general guidelines on how to implement RDT testing in your healthcare setting.

Links to more information