A study published in 2026 evaluated the performance of the Abbott Bioline Malaria Ag P.f/P.v/Pan rapid diagnostic test (RDT) against quantitative PCR (qPCR) and microscopy in the Gedeo Zone of southern Ethiopia, where Plasmodium falciparum and P. vivax are co-endemic. The research, conducted by scientists from the Ethiopian Public Health Institute and partners, aimed to address limitations of conventional HRP2-based RDTs, including low sensitivity for low parasitemia and false negatives due to pfhrp2/3 gene deletions.
The study enrolled 1,200 febrile patients from health facilities in the region. Using qPCR as the gold standard, the multi-antigen RDT demonstrated a sensitivity of 94.2% for P. falciparum and 91.5% for P. vivax, compared to 78.3% and 72.1% for microscopy, respectively. Specificity exceeded 98% for all methods. The RDT also correctly identified mixed infections in 12 cases where microscopy missed them.
Importantly, the Bioline test detected P. falciparum in 8% of samples with pfhrp2/3 deletions, which standard HRP2-based RDTs failed to identify. The authors recommend integrating multi-antigen RDTs into routine malaria surveillance in areas with high prevalence of gene deletions and mixed infections, to improve case management and reduce transmission.
