Interpretation guide: MULTI BAND tests

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Multi-band RDT tests

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RESULT PATTERN 1

Failed test: 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) and no band appears in the specifc or pan malaria area.

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 ]

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Failed test: No band appears in the control area (black arrow):

RESULT PATTERN 3

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 3

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, mutation ]
• 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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(3) No band appears

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The most common cause is infection is present with a malaria species not detected by the specific antibody Possible alternatives: The specific band has failed (see causes above) but pan-malaria antigen still detects that species No malaria is present and the band in the pan-malaria area is a false positive (cross reaction)

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(4) A band appears in both the species-specific and pan malarial area

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

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A single specific species and is detected by specific and pan-malaria antigens (95%) There are two species present in the sample (5%) False positive result in both bands (least common cause)

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