These kits also have major
limitations in their abilities to identify nonfalciparum malaria.
Since HRP2 (the target antigen in the ICT kit) is expressed
only by P. falciparum, this test could be expected to give negative
results for P. vivax, P. ovale, or P. malariae infections;
many cases of nonfalciparum malaria may therefore be misdiagnosed
as malaria negative. Finally, there is evidence that
some P. falciparum strains also lack the HRP2 gene and will
therefore never give a positive result with this test (38). With
the PCR assay as the gold standard test, there were no falsepositive
results with the ICT test in our hands