Abstract:
Identifying the aetiology of fever is challenging in paediatric patients,
particularly in resource-limited settings like Malawi. Most infectious diseases,
including malaria, present with overlapping clinical signs associated with fever.
This study aimed to identify specific serum biomarkers that differentiate
malaria from non-malarial fever in paediatric patients in Blantyre, Malawi.
Ninety archived serum samples obtained from paediatric patients who presented
with fever were grouped into non-malarial (n=25), malarial (n=46) and healthy
controls (n=19) based on temperature and mRDT results. Serum samples were
used to measure the concentration of CRP, ICAM-1, IL -6, IL-1β, IL -10, Ang-
2 and vWF-1 biomarkers using Luminex xMAP® technology. The biomarker
and haematology results obtained from participants’ records were analysed
using R statistics software. Malaria cases presented with a higher temperature
(p=0.0089), low platelet counts (p=0.02) and haemoglobin levels (p=0.01)
compared to non-malarial fever. Malarial fever had elevated IL-6
(AUROC=0.66, p= 0.04), IL-10 (AUROC = 0.81, p= ≤0.0001) and CRP
(AUROC=0.60, p=0.09) compared to non-malarial fever and controls. Nonmalarial
fever had elevated IL-1β (AUROC =0.9, p=0.02), ICAM-1 (AUROC=
0.76, p= <0.05), Ang -2 (AUROC=0.79, p=0.005), vWF-1 (AUROC=0.71, p ≤
0.001) compared to malaria and controls. IL-10 and IL-1β correctly differentiate
malarial fever from non-malarial fever with IL-10 levels increased in malarial
fever and IL-1β increased in non-malarial fever. These biomarkers can
significantly enhance diagnostic accuracy and treatment outcomes in resourcelimited
settings and can be effectively utilized in point-of-care testing.
