0 Recommendations

India bans Antibody Detecting Rapid Diagnostic Tests for routine diagnosis of malaria

By Madhukar Pai Moderator | 04 Apr, 2018

Please see this Indian government order on malaria antibody detection rapid tests.

Would like to hear from our malaria colleagues on whether this is a good strategy. Do other countries allow the use of such tests?





Ruth MCNERNEY Replied at 6:50 AM, 5 Apr 2018

I attach the latest on malaria RDTs from WHO, updated January 2018. 'Recommended selection criteria for procurement of malaria rapid diagnostic tests' The tests discussed are based on antigen detection. I know nothing about Ab based tests, but would have thought having some Ab against the parasite might be a good thing.

Attached resource:

Charles Magiri Replied at 9:33 AM, 5 Apr 2018

I know most people in malaria endemic area especially in Kenya, have antibodies against malaria species found in the country such Pf, Pm and Po. Therefore, if one uses and antibody detection kits, all those people who have been exposed or have suffered from malaria will be positive for the antibodies which may lead to unnecessary treatment that may lead to anti malaria drug resistance.
I am therefore supporting the ban on malaria antibody RDTs kits.

SUMIT MITRA Replied at 10:57 AM, 5 Apr 2018

Without being judgemental, guess this will ultimately help patients.

After all we do wants tests that are both specific and sensitive.

Suranjeen Pallipamula Replied at 1:00 PM, 5 Apr 2018

India was the first country to ban antibody testing in tuberculosis in 2012, which often led to misdiagnose of TB.
Now it's the turn for antibody testing in Malaria.
All RDK within the government programs are antigen testing kits.

DR PRADEEP SURI Replied at 10:53 PM, 5 Apr 2018

This test should have been banned long ago. For me this is a no brainer.
Anyway better late than never. I think the government should also ban all
card detection tests for dengue as well and only allow NS1 and Dengue IgM
ELISA to be done for confirmation of Dengue and not use mild words like
discouraged as given in National Vector Borne Disease Program.

Jane Carter Replied at 1:43 AM, 6 Apr 2018

There is still a use for serological tests, but it is very important that they are never used for diagnosing malaria.
Serological tests can be useful to identify people who have recently or in the past been infected with malaria. So they can be useful for monitoring changes in malaria prevalence and for identifying communities where transmission is still occurring as it is much more practical to screen a large number of individuals who have had past infection than to identify a very few individuals who may have current, asymptomatic infection. These tests may therefore be useful in malaria elimination programmes.

Jane Carter
Amref Health Africa

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