Malaria self-testing by travellers: opportunities and limitations

Accurate and timely treatment of imported malaria requires rapid and reliable diagnosis. The availability of a rapid and reliable diagnostic test could improve the quality of malaria diagnosis in febrile travelers after their return to non-endemic countries. Rapid and simple immuno-chromatographic tests have been marketed for several years. Dipstick tests for malaria diagnosis are still a potentially very useful additional tool. Trained laboratory personal have in general no problems in doing the tests. Also, the dipsticks are very valuable tools for use in epidemiological field studies. However, sensitivity and specificity of dipstick tests are still below that of trained microscopists. Exclusion of malaria should never be based on a negative dipstick test alone. Self-use of dipstick tests for malaria diagnosis by travelers should not be recommended routinely as there is enough evidence that performance and interpretation of results by the traveler is uncertain. Dipstick tests can only be recommended to travelers for specific situations (i.e. long term stay, far away from medical assistance, expedition-type travel) after appropriate instruction and training, including a successful performance of the test procedure.