Introduction: Pregnancy raises specific challenges for malaria diagnosis because of the parasite sequestration in the placenta, resulting into low parasitaemia in peripheral blood. This study aimed at assessing the performance of the ultrasensitive rapid diagnostic test (US-RDT) Alere™ Malaria Ag Pf for the detection of Plasmodium falciparum in preg-nant women.
Methodology: We conducted a cross-sectional study over a four-month period from December 2020 to March 2021. This study involved pregnant women from 04 health facilities within Nanoro health district. Thick drop/blood smear, SD Bioline Malaria Ag Pf RDT-conventional, US-RDT Alere TM and qualitative PCR were performed. Performance indicators such as sensitivity; specificity; Negative Predic-tive Value (NPV); Positive Predictive Value (PPV) and level of concordance (kappa) were calculated for comparison. PCR was the reference test.
Results: Malaria prevalence with US-RDT, with co-RDT and PCR was respectively estimated at 45%, 45.5% and 47.4%. The prevalence of asymptomatic malaria was 34.9% with PCR as the reference test. Compared with PCR, the sen-sitivity of US-RDT, co-RDT and blood smear to detect infec-tion in peripheral samples was respectively 82.3%, 75.8% and 56.6%. Sensitivity for detecting malaria in asymptom-atic women was higher with US-RDT. As a whole, the speci-ficity of the thick blood smears was better than that of US-RDT and co-RDT. The PPV and NPV of the Alere US-RDT were 86.7% and 84.8%. Concordance of results between US-RDT and PCR was good.
Conclusion: Although further studies are still needed to guide recommendations on the use of the US-RDT for ma-laria cases management during pregnancy, this study shows the potential value of this examination for diagnosing as-ymptomatic malaria during pregnancy.

Rapid diagnostic test; Malaria; Pregnant women; Nanoro.