Rapid Diagnostic Testing for Plasmodium vivax and Nonfalciparum Malaria in Endemic Areas

Abstract

Approximately 40% of the world’s population is at risk for Plasmodium vivax malaria. Resistance to chloroquine and other antimalarials is more likely for Plasmodium falciparum than other Plasmodium species, and species identification is important to select appropriate treatment. The gold standard for diagnosing malaria is microscopic examination of thick and thin blood films. However, timely, high-quality microscopy may be unavailable in resource-poor settings. Immunochromatographic rapid diagnostic tests (RDTs) are alternatives to microscopic diagnosis. Pan-specific RDTs distinguish P. falciparum (or mixed) infections from infections with only nonfalciparum species; differentiation between nonfalciparum species (P. vivax from Plasmodium ovale and Plasmodium malariae) is not possible. More recently developed, vivax-specific RDTs can detect P. vivax monoinfection or co-infection. This JAMA Clinical Evidence Synopsis summarizes a Cochrane review assessing the accuracy of RDTs for detecting P. vivax and nonfalciparum malaria in endemic countries. This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine