Interpretation guide: MULTI BAND tests

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Multi-band RDT tests

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RESULT PATTERN 1

These are invalid tests No band appears in the control area (black arrow):

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Irrespective of whether any other bands are present, this is always an invalid test: do not interpret. Report as failed test
Action:

• Repeat the test
  
• Consider the reasons for [ test failure ]

RESULT PATTERN 2

There has a valid control line (black arrow) showing a technically successful test, but no malaria bands are detected either the species specifc or pan malaria areas.

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Most likely interpretation: No malaria parasites are present

Less likely but possible interpretations:

• Malaria infection is present, but is not detected because it is below the detection limit of the test
• Bands are present but may be faint and not seen by the operator

RESULT PATTERN 3

The test has valid control line (black arrow) and has bands in the pan-specific area and the species specific area (red arrows)

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Most likely interpretation: The single species detected by the species specific band is present (this same species is also detected the pan-malaria band)

Less likely but possible interpretations:

• There are two species present in the sample (likelihood depends on country of origin, but is less likely) [ Co-infection with two species ]
• There is a false positive result causing both bands (unlikely) [ False positive reaction in RDT tests ]

RESULT PATTERN 4

The test has valid control line (black arrow) and a band in the species-specific area only (red arrow)

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Most likely interpretation: The species detected by the test is present and is the only malaria species infecting the individual

Less likely but possible interpretations:

• There is a dual-species infection, but the second species was not detected by the pan-specific band [ Co-infection with two species ]
• There is no active malaria, but patient recently received successful treatment and the antigen has not yet cleared [ Clearance of parasite antigens from blood ]
• The "specific band" is a false positive result (infrequent but observed) [ False positive reaction in RDT tests ]

RESULT PATTERN 5

The test has valid control line (black arrow) and a band in the pan-specific area only (red arrow)

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Most likely interpretation: A malaria infection is detected (pan band), but is not caused by the species detected by the specific antibody (Sp band)

Less likely but possible interpretations:

• The species detected by the specific band is present (as a single infection or dual infection), but has not been detected by the specific band prozone [ HRP2 gene deletion ]
• The patient recently received successful treatment, but the antigen has not yet cleared [ Clearance of parasite antigens from blood ]
• The "specific band" is a false positive result (infrequent but observed) [ False positive reaction in RDT tests ]

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