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The Rapid Malaria Test (Malarial Antigen Test) is an immunochromatographic lateral flow assay that detects malaria-specific pro...
Also known as: Malarial Antigen Test · Malaria RDT · Rapid Diagnostic Test for Malaria · HRP2 Malaria Test · Dengue Malaria Combo RDT
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The Rapid Malaria Test (Malarial Antigen Test) is an immunochromatographic lateral flow assay that detects malaria-specific proteins — primarily HRP2 (Histidine-Rich Protein 2, specific to P. falciparum) and pLDH (Plasmodium Lactate Dehydrogenase, detected in all Plasmodium species) — in a finger-prick blood sample within 15–20 minutes. It requires no microscopy or laboratory equipment, making it the fastest and most accessible malaria diagnostic tool and the preferred first-line test in community health settings, rural areas, and emergency triage. No fasting required.
Key benefits of this package include:
What Does the Rapid Malaria Test (Malarial Antigen) Test Measure?
| Level / Result | Possible Interpretation |
|---|---|
| Both test lines negative | No malaria antigens detected — malaria unlikely; if high clinical suspicion, confirm with smear or QBC |
| HRP2 line positive (P. falciparum band) | P. falciparum malaria detected — initiate ACT treatment; assess for severe malaria features urgently |
| pLDH line positive only (no HRP2) | Non-falciparum malaria — P. vivax most likely in India; initiate chloroquine + primaquine (check G6PD first) |
| Both HRP2 and pLDH positive | P. falciparum malaria (or mixed infection) — treat as falciparum; confirmatory smear for species if available |
| HRP2 positive after treatment | HRP2 antigen persists 2–3 weeks after P. falciparum clearance — use smear or pLDH-based test for treatment monitoring, not HRP2 |
Important Note: RDT sensitivity for P. falciparum (via HRP2) is approximately 90–95% at parasite densities above 100/µL. Sensitivity for P. vivax (via pLDH) is lower — approximately 75–90%. A negative RDT in a high-suspicion case should be followed by smear microscopy or QBC. HRP2 antigen persists after parasite clearance — do not use HRP2-based RDT to confirm treatment success; use smear or pLDH-RDT instead. All positive results require physician review.
HRP2 Deletion — An Emerging Diagnostic Challenge: In some regions of India (particularly northeast states) and globally, P. falciparum strains with deletions in the HRP2 and HRP3 genes have been reported. These deletion mutants produce no HRP2 antigen — causing false-negative results on HRP2-based RDTs despite genuine P. falciparum infection. This is an emerging concern for malaria control programmes. In areas with reported HRP2-deletion prevalence, pan-pLDH-based or smear-based diagnosis should supplement RDT testing. Medall's laboratory uses multi-antigen RDTs to maximise detection.
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