810 Field evaluation of a malaria rapid diagnostic test ( ICT Pf )

Malaria can be diagnosed using several approaches including clinical presumptive diagnosis, microscopy, polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA) and malaria rapid diagnostic tests (MRDTs),1 of which microscopy remains the ‘gold standard’.2 Since microscopy requires highly skilled staff, electricity, microscopes and laboratory reagents, its use is restricted to appropriately equipped and staffed laboratories. In district primary health care settings, RDTs are more appropriate for diagnosis because they are easy to use and inexpensive, as electricity or highly skilled staff are not needed.1 Three key factors affect the accuracy of RDTs: manufacturing standards, end user proficiency in conducting test and interpreting the results, and the environment in which the tests are stored and transported (ideally below 30oC).2 Three malaria parasite target antigens can be detected by MRDT technology: histidine-rich protein II (HRPII), which is found only in Plasmodium falciparum; and parasite lactate dehydrogenase (PLDH) and aldolase, present in all Plasmodium species.1 The HRPII antigen detection test is suitable for South Africa because species other than P. falciparum are very rare.3