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Field and laboratory studies were carried out in October and November 2005 to provide a comparative evaluation of the performance of three rapid malaria detection tests, two of which were recently introduced (the CareStartTM Malaria test and the SD Malaria Antigen BiolineTM test) and the well-known OptiMAL-ITTM test. Compared with microscopy, the sensitivity of the three tests to detect Plasmodium falciparum malaria was 97% for the CareStartTM Malaria test, 89.4% for the SD Malaria Antigen BiolineTM test, and 92.6% for the OptiMAL-ITTM test. The three tests were less sensitive in detecting non-P. falciparum infections, and the sensitivity decreased at levels of parasitemia 
500 parasites/µL for P. falciparum and 5,000 parasites/µL for other Plasmodium spp. On the basis of World Health Organization recommendations, only the CareStartTM Malaria test and the OptiMAL-ITTM test had sensitivities greater than 95% for samples with parasitemias 
100 parasites/µL.
Received May 24, 2006. Accepted for publication October 24, 2006.
Acknowledgments: We thank the patients for participating in the study, and the Ministry of Health of Madagascar for allowing access to malaria patients. We also thank the staff of the principal recipient of the Global Fund project round 4 for Madagascar and the National Malaria Control program, in particular Dr. Paul Richard Ralainirina and Dr. Philémon Tafangy, for their cooperation.
Financial support: This work was supported by the three test suppliers and the Global Fund Project for Madagascar round 3 (Community Action to Roll Back Malaria, Grant number: MDG-304-G05-M).
* Address correspondence to Didier Menard, Malaria Research Unit, Institut Pasteur de Madagascar BP 1274, Antananarivo, Madagascar. E-mail: dmenard{at}pasteur.mg
Authors’ addresses: Arsène Ratsimbasoa and Arthur Randriamanantena, Epidemiology Unit, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar. Rogelin Raherinjafy, Noéline Rasoarilalao, and Didier Ménard, Malaria Unit Research, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar, Telephone: 261-20-22-412-72, Fax: 261-20-22-415-34, E-mail: dmenard{at}pasteur.mg.
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