How accurately did a rapid malaria test detect infections in a field evaluation?

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A field team evaluated Determine malaria pf, a rapid immunochromatographic malaria test, in the epidemic-affected forest setting of Chhindwara district, Madhya Pradesh, central India. In October or November 1999, they screened 526 fever cases for Plasmodium falciparum. Those found to be infected were treated with sulfadoxine-pyrimethamine and primaquine.

Using microscopy as the gold standard, the test had 98% sensitivity and 87% specificity. Its positive predictive value was 88%, and its negative predictive value was 98%.

In follow-up of 64 subjects on day 7 after treatment, 20% of those who then appeared smear-negative still had antigen in their blood, while 34% of the subjects were still smear-positive for asexual parasites. The test was very easy to perform, and field workers could read its results reliably without supervision. The researchers concluded that its ease of use could make it useful for malaria management, particularly in remote and inaccessible areas, provided its accuracy can be assured and it can be made affordable.