Multiplex Rapid Test with Acceptable Diagnosis Performance as a Solution to Increase Diagnosis of Hepatitis B and C Viruses in Pregnant Women in an Area of High Prevalence of Both Hepatitis Viruses Associated with HIV

Background and Objective: HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are very widespread in the world, however, less than 20% of the people affected are diagnosed and treated. This study aimed to determine the prevalence of HIV, HCV and HBV co-infections in pregnant women at Bangui Community University Hospital and the cost of screening. Methods: A cross-sectional study involving consenting pregnant women who came for antenatal care was performed. HIV, HCV antibodies and HBV antigens were detected using Exacto Triplex? HIV/HCV/HBsAg rapid test, cross-validated by ELISA tests. Sociodemographic and professional data, the modes of transmission and prevention of HIV and both hepatitis viruses were collected in a standard sheet and analyzed using the Epi-Info software version 7. Results: Pregnant women aged 15 to 24 were the most affected (45.3%);high school girls (46.0%), and pregnant women living in cohabitation (65.3%) were the most represented. Twenty-five (16.7%) worked in the formal sector, 12.7% were unemployed housewives and the remainder in the informal sector. The prevalence of HIV, HBV, and HCV viruses was 11.8%, 21.9% and 22.2%, respectively. The prevalence of co-infections was 8.6% for HIV-HBV, 10.2% for HIV-HCV, 14.7% for HBV-HCV and 6.5% for HIV-HBV-HCV. All positive results and 10% of negative results by the rapid test were confirmed by ELISA tests. The serology of the three viruses costs 39,000 FCFA (60 Euros) by ELISA compared to 10,000 FCFA (15.00 Euros) with Exacto Triplex? HIV/HCV/AgHBs (BioSynex, Strasbourg, France). Conclusion: The low level of education and awareness of hepatitis are barriers to development and indicate the importance of improving the literacy rate of women in the Central African Republic (CAR). Likewise, the high prevalence of the three viruses shows the need for the urgent establishment of a national program to combat viral hepatitis in the CAR.

Rapid testing methods for food contaminants and toxicants

Food safety is one of the major concerns in every country regardless of the economic and social development. The frequent occurrence of food scandals in the world has led the Chinese government to implement several strategies to fortify the food supply system to a high food safety standard. This relies heavily on laboratory testing services but conventional methods for detection of food contaminants and toxicants are limited by sophisticated sample preparation procedures, long analysis time, large instruments and professional personnel to meet the increasing demands. In this review, we have incorporated most of the current and potential rapid detection methods for many notorious food contaminants and toxicants including microbial agents, toxic ions, pesticides, veterinary drugs and preservatives, as well as detection of genetically modified food genes and adulterated edible oil. Development of rapid, accurate, easy-to-use and affordable testing methods could urge food handlers and the public to actively screen for food contaminants and toxicants instead of passively relying on monitoring by the government examination facility. This review also provides several recommendations including how to encourage the public to engage in the food safety management system and provide optimal education and financial assistance that may improve the current Chinese food safety control system.

Tire Dynamics Modeling Method Based on Rapid Test Method

Combined with the tire dynamics theoretical model,a rapid test method to obtain tire lateral and longitudinal both steady-state and transient characteristics only based on the tire quasi-steady-state test results is proposed.For steady state data extraction,the test time of the rapid test method is half that of the conventional test method.For transient tire characteristics the rapid test method omits the traditional tire test totally.At the mean time the accuracy of the two method is much closed.The rapid test method is explained theoretically and the test process is designed.The key parameters of tire are extracted and the comparison is made between rapid test and traditional test method.The result show that the identification accuracy based on the rapid test method is almost equal to the accuracy of the conventional one.Then,the heat generated during the rapid test method and that generated during the conventional test are calculated separately.The comparison shows that the heat generated during the rapid test is much smaller than the heat generated during the conventional test process.This benefits to the reduction of tire wear and the consistency of test results.Finally,it can be concluded that the fast test method can efficiently,accurately and energy-efficiently measure the steady-state and transient characteristics of the tire.

Research on a Rapid Test Method of Dry Basis Weight of Paper-process Reconstituted Tobacco

This study aimed to optimize the rapid test factors of dry basis weight of reconstituted tobacco, in order to afford a reference test method for companies which produce reconstituted tobacco to better control the basis weight and coating ratio on line. The dry basis weight of reconstituted tobacco was tested by fast method and normal oven method individually. And the effects on the test values of different test factors such as temperature, time and the number of baking sheets were studied. Then the test values of these two methods were compared, so the proper factors of rapid test method were determined. As the baking temperature rose from 130 ℃ to 150 ℃, and the baking time rose from 1 min to 2 min, the difference between fast test method and normal oven method grew, and when the number of baking pieces rose from 3 pieces to 5 pieces, the difference between the two methods went down. The optimum test condition was baking temperature of 130 ℃, baking time of 1 min, and baking sample sheet number of 5. Under this condition, the value of fast test method was the closest to the test value of normal oven method, and meanwhile, the test factor was more proper for testing on line. The study will provide a reference for online controlling of dry basis weight and coating ratio of reconstituted tobacco.

Seroprevalence, Importance of Rapid Testing and Factors Associated with HBsAg Carriage in Pregnancy in Three Referral Maternity Hospitals in Mono (Benin), in 2020

Introduction Difficulties in accessing the screening test for viral hepatitis B in maternity wards could be a factor in underestimating the prevalence of anti-HBV antibodies. The rapid diagnostic orientation test (RDOT) could improve seroprevalence and obstetrical prognosis. The aim of this study was to use the rapid diagnostic orientation test (RDOT) to determine the seroprevalence of HBs antigen carriage in pregnant women while highlighting the associated factors. Methods This was a cross-sectional and descriptive study that took place from October to December 2020 (three months) in three (03) reference maternities in western Benin (Mono). Consenting pregnant women received in prenatal consultation had been screened by RDOT. Positive cases were confirmed by ELISA test. The follow-up of these cases made it possible to establish the obstetrical prognosis. Results Of 201 women studied, 11 (5.5%) were positive for RDOT HBV and confirmed by the ELISA test. The factors associated with HBsAg carriage during pregnancy were multiple sexual partnerships (p = 0.01), female circumcision (p = 0.0001), and ignorance of prior HBV serological status (p = 0.0001). No influence of hepatitis B on pregnancy was noted. Conclusion The seroprevalence of hepatitis B in pregnancy was intermediate in the reference maternities of western Benin. The associated factors were multiple sexual partnerships, female circumcision and unawareness of prior HBV status. Free RDOT in maternity wards would improve early detection and management of viral hepatitis B in pregnancy.

Feasibility of Using Two versus Three Rapid Tests for HIV Diagnosis in India: Analysis of Public Health Program Data

Under India’s National AIDS Control Program (NACP), WHO recommended strategy of using three rapid tests is adopted for diagnosis of HIV in an asymptomatic individual. Since the NACP has a stringent kit evaluation procedure and due to the availability of newer third generation Rapid Diagnostic Tests (RDTs) it may be possible to adapt two test strategy for HIV diagnosis instead of the recommended three test strategy. The authors reviewed programmatic data on HIV testing to explore whether use of two rapid tests for HIV diagnosis as against three tests could be a feasible approach without compromising the quality and readability of testing. Data on the HIV diagnosis performed on serum specimens collected for the period of one year (2011-12) from 82 Integrated Testing and Counselling Centers (ICTCs) or Prevention of Parent to Child Transmission Centers (PPTCTs) associated with State reference Laboratories (SRLs) was analysed. Out of 654258 results that were analysed 25168 (3.84%) specimens were positives. It was observed that both two and three test algorithms provided similar results for majority (>99%) of the HIV positive specimens. Discordance was observed in labelling of specimen with inconclusive status (N = 21), however the true status of these samples could not be obtained. The analysis indicated that the use of two test algorithm will have programmatic benefits in terms of reduced financial burden to the programme and ease of procurement, shipment and storage before and after distribution without comprising the quality of the testing. The prospective study would confirm this observation.

Evaluation of a Rapid Diagnostic Test, Boson Biotech SARS CoV-2 Ag, for the Detection of SARS-CoV-2 in Gabon

1) Background: Rapid and acurate diagnostic testing for case identification, quarantine, and contact tracing is essential for managing the COVID 19 pandemic. Rapid antigen detection tests are available, however, it is important to evaluate their performances before use. We tested a rapid antigen detection of SARS-CoV-2, based on the immunochromatography (Boson Biotech SARS-CoV-2 Ag Test (Xiamen Boson Biotech Co., Ltd., China)) and the results were compared with the real time reverse transcriptase-Polymerase chain reaction (RT-PCR) (Gold standard) results;2) Methods: From November 2021 to December 2021, samples were collected from symptomatic patients and asymptomatic individuals referred for testing in a hospital during the second pandemic wave in Gabon. All these participants attending “CTA Angondjé”, a field hospital set up as part of the management of COVID-19 in Gabon. Two nasopharyngeal swabs were collected in all the patients, one for Ag test and the other for RT-PCR;3) Results: A total of 300 samples were collected from 189 symptomatic and 111 asymptomatic individuals. The sensitivity and specificity of the antigen test were 82.5% [95%CI 73.8 - 89.3] and 97.9 % [95%CI 92.2 - 98.2] respectively, and the diagnostic accuracy was 84.4% (95% CI: 79.8 - 88.3%). The antigen test was more likely to be positive for samples with RT-PCR Ct values ≤ 32, with a sensitivity of 89.8%;4) Conclusions: The Boson Biotech SARS-CoV-2 Ag Test has good sensitivity and can detect SARS-CoV-2 infection, especially among symptomatic individuals with low viral load. This test could be incorporated into efficient testing algorithms as an alternative to PCR to decrease diagnostic delays and curb viral transmission.

Diagnostic evaluation of rapid tests for scrub typhus in the Indian population is needed

Background:Owing to frequent outbreaks witnessed in different parts of the country in the recent past,scrub typhus is being described as a re-emerging infectious disease in India.Differentiating scrub typhus from other endemic diseases like malaria,leptospirosis,dengue fever,typhoid,etc.is difficult due to overlapping clinical features and a lower positivity for eschars in Asian populations.Hence,the diagnosis heavily relies on laboratory tests.Discussion:Costs and the need of technical expertise limit the wide use of indirect immunoperoxidase or immunofluorescence assays,ELISA and PCR.The Weil-Felix test is the most commonly used and least expensive serological test,but lacks both sensitivity and specificity.Hence,the diagnosis of scrub typhus is often delayed or overlooked.With due consideration of the cost,rapidity,single test result and simplicity of interpretation,rapid diagnostic tests have come into vogue.However,evaluation of rapid diagnostic tests for scrub typhus in the Indian population is needed to justify or discourage their use.Conclusion:Research studies are needed to find the most suitable test in terms of the rapidity of the result,simplicity of the procedure,ease of interpretation and cost to be used in the Indian populace.

Development of novel-nanobody-based lateral-flow immunochromatographic strip test for rapid detection of recombinant human interferon a2b

Recombinant human interferon a2b(rhIFNa2b)is widely used as an antiviral therapy agent for the treatment of hepatitis B and hepatitis C.The current identification test for rhIFNa2b is complex.In this study,an anti-rhIFNa2b nanobody was discovered and used for the development of a rapid lateral flow strip for the identification of rhIFNa2b.RhIFNa2b was used to immunize an alpaca,which established a phage nanobody library.After five steps of enrichment,the nanobody I22,which specifically bound rhIFNa2b,was isolated and inserted into the prokaryotic expression vector pET28a.After subsequent purification,the physicochemical properties of the nanobody were determined.A semiquantitative detection and rapid identification assay of rhIFNa2b was developed using this novel nanobody.To develop a rapid test,the nanobody I22 was coupled with a colloidal gold to produce lateral-flow test strips.The developed rhIFNa2b detection assay had a limit of detection of 1 mg/mL.The isolation of I22 and successful construction of a lateral-flow immunochromatographic test strip demonstrated the feasibility of performing ligand-binding assays on a lateral-flow test strip using recombinant protein products.The principle of this novel assay is generally applicable for the rapid testing of other commercial products,with a great potential for routine use in detecting counterfeit recombinant protein products.

A Mew Technique to Rapidly Test Agrochemicai Residues In Fruits and Vegetables

Extraction of AchE, relationship between substrate and enzyme concentration, and inhibition effects of the agrochemicals to AchE are discussed in this paper. Through the re-search, the proper AchE concentration for hydrolysis of 1 ml 1mmol/L substrate and I50 val-ues of the agrochemicals to AchE are decided. It is proved that Asch-DTNB method is a rapid test tool for agrochemical residues in fruits and vegetables.A rapid test card has been developed with sensitivity of 0.05mg/L.

Sensitivity of a Rapid Mix Test with Combined Synthetic Antigens Derived from Mycobacterium Leprae PGL-1 for Diagnosis and Surveillance of Leprosy

Introduction: In the Americas, Brazil contributes 91.63% of the total cases and the state of Pará still has high endemia for leprosy. Objective: To analyze the performance of a rapid test for the diagnosis and epidemiological surveillance of leprosy in endemic areas. Methods: The sample consisted of 70 MB multibacillary leprosy (MB) patients, 63 paucibacillary (PB) patients, and 80 intradomiciliary consanguineous contacts (ICSCO) of patients. A rapid test with a 15-minute reading was applied using two prototypes: prototype 1, double test with trisaccharide antigen (NT-P-BSA) at 1a. line (83.2 ng/test) and disaccharide antigen (ND-O-BSA) at 2a. (83.2 ng/test), both with a flow of 0.08 μL/mm with a 10 μC membrane, anti-IgM conjugate with a flow of 0.040 μL/mm and a Tris-Triton and prototype 2 runner buffer with MIX antigen (trisaccharide + disaccharide) in the same concentrations and conditions of prototype 1. Results: The comparison of the MIX test positivity rate and the disaccharide or trisaccharide doublet test across all samples was statistically significant, demonstrating that the MIX test had higher seropositivity rates compared to the ND-O-BSA or NT-P-BSA. It was demonstrated that the MIX test showed a good performance, with 25.39% of the PB patients negative for the disaccharide and trisaccharide duplet test, but positive for MIX. Conclusions: These data suggest the potential for further optimizing the performance by adding other synthetic antigens to the MIX antigens.

Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test

AIM:To evaluate the influence of multiple samplings during esophagogastr oduodenoscopy(EGD) on the accuracy of the rapid urease test,and the validity of newly developed rapid urease tests,HelicotecUT plus test and HelicotecUT test,CLO test and ProntoDry test.METHODS:A total of 355 patients undergoing EGD for dyspepsia were included.Their Helicobacter pylori(H.pylori) treatment status was either nave or eradicated.Six biopsy specimens from antrum and gastric body,respectively,were obtained during EGD.Single antral specimens and dual(antrum+body) specimens were compared.Infection status of H.pylori was evaluated by three different tests:culture,histology,and four different commercially available rapid urease tests(RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test,and established CLO test and ProntoDry test.H.pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology,CLO test and ProntoDry test.RESULTS:When dual specimens were applied,sensitivity was enhanced and RUT reaction time was signif icantly reduced,regardless of their treatment status.Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs.Both newly developed RUTs showed comparable sensitivity,specif icity and accuracy to the established RUTs,regardless of patient treatment status,RUT reaction duration,and EGD biopsy sites.CONCLUSION:Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.

Establishment and Preliminary Application of a Rapid Fluorescent Focus Inhibition Test (RFFIT) for Rabies Virus

The World Health Organization (WHO) standard assay for determining levels of the rabies virus neutralization antibody (RVNA) is the rapid fluorescent focus inhibition test (RFFIT), which is used to evaluate the immunity effect after vaccination against rabies. For RFFIT, CVS-11 was used as the challenge virus, BSR cells as the adapted cells, and WHO rabies immunoglobulin (WHO STD) as the reference serum in this study. With reference to WHO and Pasteur RFFIT procedures, a micro-RFFIT procedure adapted to our laboratory was produced, and its specificity and reproducibility were tested. We tested levels of RVNA in human serum samples after immunization with different human rabies vaccines (domestic purified Vero cell rabies vaccine (PVRV) and imported purified chick embryo cell vaccine (PCECV)) using different regimens (Zagreb regimen and Essen regimen). We analyzed the levels of RVNA, and compared the immune efficacy of domestic PVRV and imported PCECV using different immunization regimens. The results showed that the immune efficacy of domestic PVRV using the Zagreb regimen was as good as that of the imported PCECV, but virus antibodies were generated more rapidly with the Zagreb regimen than with the Essen regimen. The RFFIT procedure established in our laboratory will enhance the comprehensive detection ability of institutions involved in rabies surveillance in China.

Evaluation of a Direct Rapid Immunohistochemical Test (dRIT) for Rapid Diagnosis of Rabies in Animals and Humans

Presently the gold standard diagnostic technique for rabies is the direct immunofluorescence assay （dFA） which is very expensive and requires a high level of expertise. There is a need for more economical and user friendly tests, particularly for use in developing countries. We have established one such test called the direct rapid immunohistochemical test （dRIT） for diagnosis of rabies using brain tissue. The test is based on capture of rabies nucleoprotein （N） antigen in brain smears using a cocktail of biotinylated monoclonal antibodies specific for the N protein and color development by streptavidin peroxidase-amino ethyl carbazole and counter staining with haematoxollin. The test was done in parallel with standard FAT dFA using 400 brain samples from different animals and humans. The rabies virus N protein appears under fight microscope as reddish brown particles against a light blue background. There was 100 % correlation between the results obtained by the two tests. Also, interpretation of results by dRIT was easier and only required a light microscope. To conclude, this newly developed dRIT technique promises to be a simple, cost effective diagnostic tool for rabies and will have applicability in field conditions prevalent in developing countries.

Value of a new stick-type rapid urine test for the diagnosis of Helicobacter pylori infection in the Vietnamese population

AIM: To assess the value of a new test for the diagnosis of Helicobacter pylori (H. pylori) infection, Rapirun®H. pylori Antibody Stick (Rapirun® Stick), in a Vietnamese population.

Intraprocedural gastric juice analysis as compared to rapid urease test for real-time detection of Helicobacter pylori

BACKGROUND Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy(UGE)to perform gastric juice analysis and real-time detection of Helicobacter pylori(H.pylori).AIM To assess the diagnostic performance of this technology and its impact on the management of H.pylori in the real-life clinical setting.METHODS Patients undergoing routine UGE were prospectively recruited.Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test(RUT).Gastric juice sampling and analysis was performed using the Endofaster,and the diagnosis of H.pylori was based on real-time ammonium measurements.Histological detection of H.pylori served as the diagnostic gold standard for comparing Endofaster-based H.pylori diagnosis with RUT-based H.pylori detection.RESULTS A total of 198 patients were prospectively enrolled in an H.pylori diagnostic study by Endofasterbased gastric juice analysis(EGJA)during the UGE.Biopsies for RUT and histological assessment were performed on 161 patients(82 men and 79 women,mean age 54.8±19.2 years).H.pylori infection was detected by histology in 47(29.2%)patients.Overall,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value(NPV)for H.pylori diagnosis by EGJA were 91.5%,93.0%,92.6%,84.3%,and 96.4%,respectively.In patients on treatment with proton pump inhibitors,diagnostic sensitivity was reduced by 27.3%,while specificity and NPV were unaffected.EGJA and RUT were comparable in diagnostic performance and highly concordant in H.pylori detection(κ-value=0.85).CONCLUSION Endofaster allows for rapid and highly accurate detection of H.pylori during gastroscopy.This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.

Comparison of a rapid diagnostic test and microimmunofluorescence assay for detecting antibody to Orientia tsutsugamushi in scrub typhus patients in China

Objective:To evaluate the detection of IgM and IgG antibodies to Orientia tsutsugamushi(O. tsutsugamushi) by rapid diagnostic test(RDT) and microimmunofluorescence assay(ml FA). Methods:RDT using a mixture of recombinant 56-kDa proteins of O.tsutsugamushi and mIFA assay were performed on 20 patients from Fujian and 13 patients from Yunnan Province,and 82 sera samples from healthy farmers in Anhui Province and Beijing City in 2009.Comparison of the RDT and mIFA assay was performed by using X test and the P level of 【0.05 was considered to be significance.Results:Among these 82 normal sera samples,the specificity of RDT was 100%for both IgM and IgG tests.In 33 samples from patients with scrub typhus,5 cases were positively detected earlier by RDT than by mIFA in IgM test,and 2 cases were positive in IgG test.Sensitivities of RDT were 93.9%and 90.9%for IgM and IgG,respectively.The sensitivity of combination lest of IgM and IgG was 100%.Geometric mean titer diluted sera from confirmed cases by IFA and RDT assay were 1:37 vs.1:113(P【0.001) in IgM test and 1:99 vs.1:279 (P【0.05) in IgG test.Conclusions:RDT is more sensitivite than mIFA in the early diagnosis of scrub typhus and it is particularly applicable in rural areas.

Field evaluation of COVID-19 rapid antigen test:Are rapid antigen tests less reliable among the elderly?

BACKGROUND The global outbreak of coronavirus disease 2019(COVID-19)leads to the development of accessible and cost-effective rapid antigen-detection tests(RATs),as quick and accurate diagnosis is crucial to curb the pandemic.AIM To evaluate the Humasis COVID-19 Ag Test(Humasis Co.,Ltd.,Gyeonggi-do,Republic of Korea)in the diagnosis of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).METHODS This retrospective study was carried out at the Croatian Institute of Public Health and included patients with clinical symptoms of COVID-19 lasting no longer than 5 d prior to testing,whose nasopharyngeal swabs were primarily tested with RAT.Negative RAT samples underwent confirmatory real-time reverse transcription-polymerase chain reaction(RT-PCR).Diagnostic efficacy was determined compared to RT-PCR.The patients were divided into three age groups(<18,19-65,>65 years).Statistical analysis was performed with the significance level set at P<0.05.RESULTSIn total,2490 symptomatic patients were tested;953 samples were positive on RAT,and 1537 werenegative.All negative RAT samples were subjected to RT-PCR;266 samples were positive andmarked as false-negative results on RAT.The calculated negative predictive value as a measure ofRAT efficacy was 82.69%.The χ^(2) test and Kruskal-Wallis test showed a significant difference in theproportion of false negatives(P<0.001)and RT-PCR cycle(Ct)values for false-negative RATs(P=0.012)among the age groups.The young age group was significantly less likely to be falsenegative,whereas the false negatives from the elderly group experienced significantly lower Ctvalues than the other two age groups.CONCLUSIONEvaluated RAT demonstrated satisfactory performance with more reliable results in youngerpatients.Humasis COVID-19 Ag RAT is potentially a valuable tool in areas where access tomolecular methods is limited;however,RT-PCR remains a gold standard for SARS-CoV-2detection.

A comparative laboratory diagnosis of malaria:microscopy versus rapid diagnostic test kits

Objective:To compare the two methods of rapid diagnostic tests(RDTs)and microscopy in the diagnosis of malaria.Methods:RDTs and microscopy were carried out to diagnose malaria. Percentage malaria parasitaemia was calculated on thin films and all non-acute cases of plasmodiasis with less than 0.001%malaria parasitaemia were regarded as negative.Results were simply presented as percentage positive of the total number of patients under study.The results of RDTs were compared to those of microscopy while those of RDTs based on antigen were compared to those of RDTs based on antibody.Patients' follow-up was made for all cases.Results: All the 200 patients under present study tested positive to RDTs based on malaria antibodies(serum)method(100%).128 out of 200 tested positive to RDTs based on malaria antigen(whole blood)method(64%),while 118 out of 200 patients under present study tested positive to visual microscopy of Lieshman and diluted Giemsa(59%).All patients that tested positive to microscopy also tested positive to RDTs based on antigen.All patients on the second day of follow-up were non-febrile and had antimalaria drugs.Conclusions;We conclude based on the present study that the RDTs based on malaria antigen(whole blood)method is as specific as the traditional microscopy and even appears more sensitive than microscopy.The RDTs based on antibody(serum)method is unspecific thus it should not be encouraged.It is most likely that Africa being an endemic region,formation of certain levels of malaria antibody may not be uncommon.The present study also supports the opinion that a good number of febrile cases is not due to malaria. We support WHO's report on cost effectiveness of RDTs but,recommend that only the antigen based method should possibly,be adopted in Africa and other malaria endemic regions of the world.