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