Madagascar's Malaria Tests: How Well Do They Work?

Malaria in Madagascar is a big deal. The World Health Organization says to use special tests to spot malaria infections before treating them. In 2023, scientists checked out two quick tests, Bioline™ Malaria Ag Pf/Pan and Bioline™ Malaria Ag Pf/Pv, in two places with different types of malaria: Ifanadiana (P. falciparum) and Mandoto (P. vivax). They tested both folks with symptoms and without, aged 3 to 81. The tests were done on blood from finger pricks, then compared to microscope and PCR results. For P. falciparum and non-falciparum/vivax malaria, the tests were pretty accurate in people with symptoms, catching most cases (96. 5% and 91. 5% sensitivity) but missing some (76% specificity). In folks without symptoms, the tests caught fewer cases (90. 3% and 33. 3% sensitivity for Pf/Pan, 80. 6% and 0% for Pf/Pv). However, they wrongly spotted malaria in some people who didn't have it (85. 4% and 86% specificity). The tests' performance changes based on where you are. This shows how important it is to think carefully about using these tests based on local malaria types and patient situations. When other tests aren't available, these quick tests can be used.