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Table 2 Analysis of test type for a combination HS-RDT to support ACD

From: International survey to identify diagnostic needs to support malaria elimination: guiding the development of combination highly sensitive rapid diagnostic tests

Test type Interpretation and treatment Advantages Disadvantages Comments
Pan/Pf/Pv Pan(+)/Pf(+)/Pv(+) → ACT + PQ Pan(+)/Pf(+)/Pv() → ACT Pan(+)/Pf()/Pv(+) → CQ + PQ Pan(+)/Pf()/Pv() → CQ Detects all species Differentiates Pf Allows targeted Pv radical cure Does not target Po radical cure Helpful for surveillance in drug resistant areas because differentiates Pf Difficult interpretation by end user Technically challenging
Pan/Pf Pan(+)/Pf(+) → ACT Pan(+)/Pf() → CQ(+PQ) Detects all species Differentiates Pf Pan(+)/Pf(+) could be a mixed infection requiring PQ Pan(+)/Pf() would not receive PQ if Pv not confirmed Helpful for surveillance in drug resistant areas because differentiates Pf 29% of current RDT volume market Common, familiar format
Pf/Pv Pf(+)/Pv(+) → ACT + PQ Pf(+)/Pv() → ACT Pf()/Pv(+) → CQ + PQ Differentiates Pf Allows targeted Pv radical cure Does not detect Pm/Po/Pk Does not target Po radical cure Helpful for surveillance in drug resistant areas because differentiates Pf 6% of current RDT volume market
Pf/Pvom Pf(+)/Pvom(+) → ACT + PQ Pf(+)/Pvom() → ACT Pf()/Pvom(+) → CQ + PQ Differentiates Pf Allows targeted Pv and Po radical cure Over-treatment of Pm with PQ Does not detect Pk Helpful for surveillance in drug resistant areas because differentiates Pf Commercial product available
Pan/Pvo Pan(+)/Pvo(+) → ACT + PQ Pan(+)/Pvo() → ACT Detects all species Allows targeted Pv and Po radical cure Does not differentiate Pf Shift from CQ to ACT for non-falciparum Limited surveillance data on species; speciation at reference lab required
Pan only Pan(+) → ACT + PQ Detects all species Over-treatment of Pf/Pm/Pk with PQ Does not differentiate Pf Shift from CQ to ACT for non-falciparum Limited surveillance data on species; speciation at reference lab required
  1. This analysis assumes that all test lines have the same limit of detection required to detect sub-microscopic infections and that glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is available and done when required
  2. HS-RDT (high sensitive rapid diagnostic test); ACD (Active Case Detection); Pan (all Plasmodium species); Pf (Plasmodium falciparum); Pv (P. vivax); Pvom (P. vivax, P. ovale, and P. malariae); Pvo (P. vivax and P. ovale); Pk (P. knowlesi); ACT (artemisinin-combination therapy); PQ (primaquine); CQ (chloroquine); NAATs (nucleic acid amplification techniques)