Comparison of the ParaSight ™-F test and the ICT Malaria Pf ™ test with the polymerase chain reaction for the diagnosis of Plasmodium falciparum malaria in travellers

Rapid and accurate methods are needed for the diagnosis of imported malaria. The ParaSight ™-F test and the ICT Malaria Pf ™ test are commercially available kits marketed for the diagnosis of Plasmodium falciparum malaria. Both tests are antigen-capture assays based on the detection of P. falciparum histidinerich protein 2 in peripheral blood. Using microscopy and a polymerase chain reaction (PCR)-based method as reference standards, we performed a ‘blinded’ comparison of these assays for the detection of P. falciparum infection in 200 febrile travellers returning from malaria-endemic areas. As determined by PCR and microscopy, 148 travellers had malaria and, of these patients, 54·7% ( 81 148 ) were infected with P. vivax only, 31·1% ( 46 148 ) with P. falciparum only, 9·5% ( 14 148 ) with P. ovale, 0·7% ( 1 148 ) with P.malariae, and 4·1% ( 6 148 ) had mixed infections. Compared to PCR, the ParaSight ™-F and ICT Malaria Pf ™ tests had initial sensitivities of 94% and 90% and specificities of 95% and 97%, respectively, for the detection of P. falciparum malaria. When discrepant samples were retested with day 0 and day 1 bloods, the sensitivities improved to 96% and 94%, respectively. The 2 remaining false negative results with the Para-Sight ™-F test and 2 of the 3 false negative results with the ICT Malaria Pf ™ test occurred in samples with