Summary ROC plot of sensitivity and specificity of RDT and PCR with peripheral blood with peripheral blood microscopy as reference test. The sensitivity of a certain test is plotted against 1-specificity, allowing comparison of both parameters at the same time for multiple tests. The rectangles, diamonds and circles represent individual studies and size of the rectangles/diamonds/circles is proportional to the number of patients included in the study. The thick round spots are the summary estimates of sensitivity and specificity for the different test types and the dotted ellipses around the spots represent the 95% confidence intervals around the summary estimates. Black (rectangles): PCR studies; Red (diamonds): studies with HRP2 based RDTs only; Green (circles): studies with RDTs, including both HRP2, pLDH and HRP2-Aldolase detecting tests. The reference test used to determine the plotted accuracies in this figure is placental histology. The inclusion of the pLDH and Aldolase-HRP2 based RDTs dramatically changes the summary estimate and confidence interval (green) compared to HRP2 tests alone (red), the sensitivity is much lower with the pLDH tests.