Malaria Antigen Test

malarial antigen test

Last Updated December 20th, 2021

What is a malaria antigen test?

A malaria antigen test is a rapid diagnostic test (RDT) that employs immunochromatographic methods in order to detect malarial antigens (proteins) in your peripheral blood. This helps in confirming the presence of the malaria parasite in your blood, and aids in arriving at a diagnosis of malaria. This test mainly detects the presence of Plasmodium falciparum-a protozoa causing the most severe form of malaria.

What is malaria?

Malaria is a potentially life-threatening disease caused by the bite of infected female Anopheles mosquito which transmits the protozoa Plasmodium into your blood stream. If untreated, malaria can lead to severe morbidity, but a timely diagnosis and intervention can lead to a speedy recovery with almost no sequelae. There are 5 species of the parasite Plasmodium which can lead to malaria. These are-

– Plasmodium falciparum
– Plasmodium malariae
– Plasmodium ovale
– Plasmodium knowlesi
– Plasmodium vivax

Apart from the bite of an infected Anopheles mosquito, malaria can also be infrequently transmitted by-

– A pregnant woman to her baby during pregnancy or delivery
– Blood transfusion
– Organ transplant
– Sharing of contaminated needles or syringes (as is common among drug addicts)

When you are bitten by an infected mosquito, the parasites enter the bloodstream and travel to the liver. After an incubation period of 1-4 weeks, the parasites enter your red blood cells (RBCs). They multiply inside these cells, which rupture within 48 to 72 hours, causing most of the symptoms of malaria to manifest.
While infection with any of the species mentioned above, if left untreated, can cause severe illness and death, infection by P. falciparum and P. knowlesi carries the gravest risk of serious multiorgan morbidity.

Why has my doctor ordered malaria antigen test for me?

Your physician may order a malaria antigen test for you if you present with the following clinical features-

– High fever
– Chills with rigors
– Excessive sweating
– Listlessness
Headache (this symptom is present in almost of the patients suffering from malaria)
Myalgia (pain in the muscles)
– Arthralgia (pain in the joints)
– Nausea/Vomiting
– Loss of appetite
– Diarrhea
– Explosions of fever, associated with chills, rigors, and sweating (every 48 or 72 hours, depending on species of the malarial parasite) is a classical sign of malaria.

Can I undergo a malaria antigen test if I am pregnant?

Yes, you can safely undergo a malaria antigen test if you are pregnant or breastfeeding your child. You should keep in mind that malaria infection in a pregnant female carries a very high risk of morbidity and mortality both for the mother and the unborn child. The malarial parasite tends to gather and reproduce in the placenta, complicating an already grim picture. A timely detection and judicious treatment can save the day for the pregnant woman and her fetus.

Can children undergo malaria antigen test?

Yes, children of all ages can undergo this test as it is a safe, risk free and easy to perform test.

Do I need to fast before a malaria antigen test?

There is no need to fast before this test. You can continue to eat and drink normally.

How should I prepare for a malaria antigen test?

No specific preparations are required before you undertake a malaria antigen test. Inform your physician if you suffer from a coagulopathy or have been taking blood thinners. Inform your physician inn detail regarding your medical history, any other drugs that you may be consuming at the time of the test and if you suffer from any drug allergy. This will help the physician in charting out a treatment plan for you in case you test positive for malaria.

Are there any risks involved?

A malarial antigen test is a very safe test. It involves only a pin prick to derive blood. So, the risks involved with the technique of venipuncture are also not seen in this case. In rare cases, however, venipuncture may be resorted to.

How is a malaria antigen test performed?

A malaria antigen test is performed as an outpatient procedure. It can be performed in a diagnostic center, in a hospital, a doctor’s office or even in the comfort and privacy of your own home. A rapid diagnostic kit is available in all stores and is stocked in the government hospitals as well. It consists of-

– Alcohol swabs
– A lancet (for pricking the finger)
– A pair of disposable gloves
– A buffer (supplied in a single bottle or dropper vial)
– Test strips (available as dipstick/cassette)
– Transfer devices (pipettes/straws)

This test can be performed in the house setting also but you need to read the instructions on the kit very carefully before you proceed with it. In a professional setting, the following steps will be followed-

– The technician will check the expiry date of the kit.

– He will open the kit and take out the contents.

– Putting on a pair of disposable gloves, the technician will clean your finger with an alcohol swab.

– He will prick your finger with a lancet and draw out blood with a pipette.

– The sample is placed on a designated spot on the RDT cassette and so is the buffer.

– The test is read according to the instructions. This is done after 20 minutes.

– A line in “C” and a line in “T” on the cassette means that you have falciparum malaria.

How long does a malaria antigen test last?

The malarial antigen test takes only 5-10 minutes to perform. But a holding time of 20 minutes is adhered to before the test is read.

When can I get the results of my test?

You can get the results of the test within 1 hour. That’s why the test is referred to as a Rapid Diagnostic Test.

What should I do if I test positive?

In case you have performed the RDT test at home or in a diagnostic center and your test shows that you are suffering from malaria, do not waste time. You should rush to your physician immediately. Malaria can be a serious disease involving multiple organs (cerebral malaria is one such catastrophic complication). Early detection and intervention are the only ways to treat a patient.

What is the treatment for malaria?

Plasmodium falciparum malaria and Plasmodium knowlesi malaria:

Quinine-based therapy is generally administered along with quinine sulfate plus doxycycline/clindamycin/pyrimethamine-sulfadoxine.

– Alternate therapies include artemether-lumefantrine, atovaquone-proguanil, or mefloquine.

– Chloroquine is the drug of choice if the parasite is known to be susceptible to chloroquine.

P vivax and P ovale malaria:

Chloroquine plus primaquine are the preferred drugs.


P malariae malaria: Chloroquine is the drug of choice.

What does a malaria antigen test cost in India?

A kit for rapid detection of malaria antigen costs about Rs 1500 in India. The cost of the kit is lower in the government hospitals.

What are the advantages and limitations of a malaria antigen test?

AdvantagesLimitations
A malaria antigen test has accuracy which is comparable to that of Polymerase chain reaction (PCR) test.It has less efficacy when parasite levels are below 100 parasites/mL of blood.
It can detect Plasmodium falciparum in parasitemias that are below the threshold of reliable microscopic species identification.There have been instances, when an RDT test has been negative in patients with a high parasite load.
It is used if the laboratory does not have enough expertise in detecting parasites in blood smears.It is not a confirmatory test. It is imperative to confirm RDT test results with a second type of screening test.
The result of the test can be obtained in a very short time. A false-positive result from an RDT may occur up to 2 weeks or more after treatment due to persistence of circulating antigens.
It is considered superior to expert microscopy. It is a costly test.

What are the other tests to detect malaria?

Blood smears (thick/thin) examination- Examination of a blood smear under a microscope is still considered to be the gold standard for the diagnosis of malaria. All the species of malarial parasite can be recognized. Blood for the examination is taken from the fingertip or the ear lobe. The sensitivity of this test can be increased by using fluorescein microscopy.

Polymerase chain reaction (PCR) assay testing– This test requires skilled technicians which are not easy to come by. This test detects malarial DNA in your blood. This test can be used for the initial diagnosis as well as ascertaining the response to anti-malarial therapy.

Nucleic acid sequence-based amplification (NASBA test)- This test can be used for the detection of malaria in the early stages when the parasite load is low. It can also be used in the field and for monitoring the response to therapy.

What is the burden of Malaria in India?

Since ages, malaria has been an important public health issue in India. According to a recent WHO report- “About 2 million confirmed malaria cases and 1,000 deaths are reported annually.” The National Malaria Control Program is committed to containing this preventable, treatable, yet potentially fatal disease.

 

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