Abstract:
Evidence-based practice in medicine requires clinical signs and symptoms of malaria to be con-
firmed by microscopic detection of the parasite in blood sample of patients. In some cases, how-
ever, such signs and symptoms persist without microscopic detection of the parasite in blood
smears, making it difficult for treatment decision to be made by medics. To help solve the above
problem and to ensure that antimalarial drugs are given to patients who actually suffer from
malaria infection, we designed this cross-sectional study to measure ESR, mIgG, Hb and parasi-
taemia levels in 78 clinically diagnosed malaria patients attending the Elmina Urban Health
Centre, in the Komenda-Edina-Eguafo-Abirem Municipal Assembly in the Central Region of
Ghana, with the view to finding alternative biomarkers for malaria infection. Apart from the Hb
levels which differed significantly (P=0.001) between the sexes, the levels of all the other meas-
ured indicators of malaria infection were comparable between the various groups. ESR corre-
lated positively with mIgG (r = 0.242, P =0.033) but negatively with Hb (r = -0.348, P = 0.002)
irrespective of age, sex or percentage parasitaemia. Our results appear to suggest that an ESR
level of twice the upper reference value of an individual may be diagnostic of malaria infection
in the presence of the appropriate recognized signs and symptoms of malaria without micro-
scopically detectable parasitaemia in the blood sample of patients. We propose that ESR and
mIgG be considered as complementary markers of malaria infection in cases of unsuccessful
microscopic detection of the malaria parasite in blood smears.
