In areas where two or more species of malaria parasites are common, only a parasitological method will permit a species diagnosis. Where mono-infection with P. vivax is common and microscopy is not available, it is recommended that a combination RDT which contains a pan-malarial antigen is used. Alternatively, RDTs specific for falciparum malaria may be used, and treatment for vivax malaria given only to cases with a negative test result but a high clinical suspicion of malaria. Where P. vivax, P. malariae or P. ovale occur almost always as a co-infection with P . falciparum, an RDT detecting P. falciparum alone is sufficient. Anti-relapse treatment with primaquine should only be given to cases with confirmed diagnosis of vivax malaria.