Serological profile among patients with malaria in secondary community hospitals in India - a multicenter cross sectional study

Abstract

Materials and methods Serological tests from patients with malaria in an observational fever study were analyzed. During April 2011November 2012, 1564 patients aged ≥5 years with fever for 2-14 days were consecutively included at seven secondary community hospitals in Tezpur (Assam), Raxaul (Bihar), Mungeli (Chhattisgarh), Ratnagiri (Maharashtra), Anantapur (Andhra Pradesh), Oddanchatram and Ambur (Tamil Nadu). Scrub typhus IgM ELISA (In Bios, USA), Leptospira IgM ELISA (Alere, Australia), Chikungunya IgM ELISA (NIV, India), Dengue rapid NS1 antigen and IgM Combo test (SD bioline, USA) were performed at the hospital sites. At the monitoring site (Benjamin M Pulimood Laboratories, Christian Medical College, Vellore, India), malaria genus mitochondrial PCR was performed on all samples and 18S species-specific PCR or sequencing performed on genus positive samples with methods as described previously (Haanshuus et al., Malaria Journal 2013). At the monitoring site Dengue IgM capture ELISA (MAC-ELISA), Scrub typhus immunofluorescence (IFA) on Scrub ELISA positive samples and Leptospira Microscopic Agglutination Test (MAT) on Leptospira ELISA positive samples were also performed. Convalescence samples for test of rise in titer were not collected due to logistical challenges. Malaria PCR was considered gold standard for the diagnosis of malaria.