Evaluation of MAL Card Rapid Test Versus Microscopic Methods For Malaria Diagnosis In Resource-Limited Rural Settings of India

ABSTRACT Background: Malaria remains a major public health concern in resource-limited rural settings, where access to reliable diagnostic tools is often constrained. The MAL Card rapid diagnostic test (RDT) offers a potential alternative to traditional microscopic methods, but its diagnostic accuracy in rural healthcare settings needs further evaluation. Objective: This study aims to compare the performance of the Advantage MAL Card rapid test with conventional microscopy for malaria diagnosis in a rural hospital in India. Methods: A retrospective study was conducted among suspected malaria patients. Blood samples were tested using both the MAL Card rapid test and microscopy (gold standard). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the MAL Card were assessed against microscopy. Results: The MAL Card rapid test demonstrated a sensitivity of 94.12% and specificity of 99.54%, with a PPV of 80% and NPV of 99.88%. While the rapid test provided quicker results, microscopy remained more accurate in detecting malaria cases. Conclusion: The MAL Card test proves to be a reliable and efficient diagnostic tool for malaria in resource-limited rural settings, offering high sensitivity, specificity, and ease of use. Its rapid turnaround time makes it a valuable first-line diagnostic method, particularly where microscopy is inaccessible. However, the risk of false positives necessitates confirmatory testing in certain cases to ensure accurate diagnosis and treatment. Despite this limitation, integrating the MAL Card into malaria control programs can enhance surveillance, support timely intervention, and contribute to reducing the malaria burden in endemic regions.