Malaria Antigen, Screen and Microscopy Smear
Test Mnemonic
MALAGS
CPT Codes
- 87899 - QTY (1)
- 87899 - QTY (1)
LOINC ®
46094-9
Aliases
- Binax Malaria
- Malaria antigen
- Malaria screen
- Plasmodium antigen
Includes
- Blood Parasite Microscopy smear, including % parasitemia (BPMSM)
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 2 - 3 mL | Whole blood | EDTA (Lavender) | Ambient | Refrigerated | Prompt delivery of specimens to the laboratory is crucial for accurate and reliable results. Laboratories that are unable to deliver specimens within a few hours of collection should conduct an initial screening for malaria, such as a Malaria Binax antigen test, before sending the specimen. This preliminary testing helps ensure timely diagnosis and effective patient management. Refer to Blood Parasite Microscopy smear, including % parasitemia for additional specimens (slides) needed to complete reflex testing. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 0.5 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | 24 hrs |
| Refrigerated | 24 hrs |
| Frozen | Unacceptable |
Days Performed
7 days a week
Turnaround Time
1 - 8 hours
Methodology
| Name | Description |
|---|---|
| Immunochromatography |
Special Info
The malaria antigen test should be treated as a STAT test and processed immediately upon receipt in the lab. It is crucial to use this test for patients who have an appropriate travel history and a strong suspicion of malaria. Blood samples must also be delivered to the lab promptly after collection to ensure the accuracy, reliability and appropriate utilization of the test results. All malaria antigen screen tests will be reflexed to Blood parasite microscopy smear, regardless of a positive or negative result.
Clinical Info
Malaria is a major parasitic disease, which is endemic in many countries in various areas of the world. Each year it causes up to 3 million deaths and close to 5 billion cases of clinical illness worldwide. The rapid malaria antigen screen has better sensitivity of detection for Plasmodium falciparum as compared to the other Plasmodium species. It provides rapid results and is designed to be used as a screening tests but all test results are paired with a blood parasite microscopy smear. The antigen test is not designed to be used for assessment of treatment efficacy or as a test-of-cure as residual plasmodium antigen may be detected several days following clearance as determined by microscopy.
Clinical Limitation
A negative test result does not exclude infection with malaria, particularly at low levels of parasitemia. Test performance depends on antigen load in the specimen and may not directly correlate with microscopy performed on the same specimen. Binax antigen test can cross react with rheumatoid factor, chronic viral infections such as hepatitis C and other parasitic infections. The Binax malaria test can be affected by the prozone effect, and both antigens may test positive due to dual infection or high levels of parasitemia. The antigen test may also remain positive for days after clearance of malarial parasitic infection. False negatives are also possible for HRP-2 negative Plasmodium falciparum species.
Clinical Reference
1. Centers for Disease Control (CDC). Evaluation and diagnosis of Malaria, June 24, 2024. https://www.cdc.gov/malaria/hcp/clinical-guidance/evaluation-diagnosis.html 2. Bobbi S. Pritt, 2023. Plasmodium and Babesia, p.13-20. Manual of Clinical Microbiology, 13th Edition. ASM Press, Washington, DC. 3. Moody, Anthony. Rapid Diagnostic Tests for Malaria Parasites. Clinical Microbiology Reviews, Jan. 2002; 15: 66-78.