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False-positive serological tests in acute malaria.

K Ghosh1, K N Javeri, D Mohanty

  • 1Institute of Immunohaematology (ICMR), 13th Floor, KEM Hospital MS Building, Parel, Mumbai-400012, India. kanjakshaghosh@hotmail.com

British Journal of Biomedical Science
|April 4, 2001
PubMed
Summary

Acute malaria infections can cause false-positive results in common serological tests like RPR and ELISA. Caution is advised when interpreting these diagnostic tests in malaria-endemic regions, especially for pyrexia of unknown origin.

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Area of Science:

  • Tropical medicine
  • Clinical immunology
  • Infectious diseases

Background:

  • Malaria is a significant public health concern in tropical countries.
  • Accurate serological diagnostics are crucial for disease management.
  • Pyrexia of unknown origin (PUO) often requires extensive diagnostic workup.

Purpose of the Study:

  • To evaluate the impact of acute malaria on the accuracy of various serological tests.
  • To determine the prevalence of false-positive reactions during malaria infection.
  • To provide guidance on interpreting serological results in malaria-endemic areas.

Main Methods:

  • A cohort of 100 acute malaria patients (Plasmodium vivax and P. falciparum) and 25 healthy controls were enrolled.
  • Standard serological tests were performed, including RPR, Widal, HIV ELISA, DCT, and RF.

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  • Follow-up testing was conducted four weeks post-recovery.

    • Main Results:

    • A significant proportion of malaria patients exhibited false-positive results across multiple serological tests during the acute phase.
    • These false-positive reactions resolved, becoming negative upon re-testing after recovery.
    • Three severe P. falciparum cases resulted in mortality, while others recovered.

    Conclusions:

    • Serological test results in patients with acute malaria, particularly in endemic regions like India, require careful interpretation.
    • False-positive serological reactions during malaria can complicate the diagnosis of other conditions, including PUO.
    • Awareness of malaria-induced serological alterations is essential for accurate clinical decision-making.