August 10, 2021

Cross Infection of Malaria and Dengue: Choosing the correct Diagnosis

Both Malaria and Dengue are endemic mosquito-borne diseases. They bring in high rates of mortality and morbidity. Their co-infection poses a worldwide public health problem. With the increase in ease of globalized travel, the risk has coupled over the years. Concurrent infections of Malaria and Dengue occur with their own set of complications. Due to relative clinical similarities of the diseases, the co-infections can get misdiagnosed. At times, the error is reporting them as mono infections. As on date, many cases of Malaria-Dengue co-infections reported from various regions in the world. Both Dengue and Malaria are difficult to differentiate, especially in co-infection. The treatment of these co-infections is very different. A delay in instituting appropriate management can be fatal.

Malaria and Dengue present similar clinical presentation. The differences are in the causative organisms and their pathogenic mechanisms. Both Dengue and Malaria coexist in thrombocytopenic patients. Especially those presenting with acute febrile illness. Anemia is frequent in concurrent infections.

Along with are decreasing platelets, hemoglobin content. There is also a rise in alanine aminotransferase levels. In India, Malaria and Dengue co-infection are more prevalent in endemic areas. Reports suggest that pregnant women are more vulnerable to co-infections. Early diagnosis has proven to be lifesaving for both mother and fetus. Co-infections show high levels of TNF and interferon-? (IFN-?) and Interleukin-6 (IL-6). Many concurrent infections with overlapping clinical manifestations. The significant symptoms are acute febrile illness, high fever, headache, nausea, and myalgia. They pose a severe diagnostic challenge as well as a management dilemma.

Using a more specific diagnosis is ideal for either condition. Detection of IgM is ideal for the diagnosis of Dengue. The test in Rapid card post-ELISA clears out any fear of cross infections. Smear microscopy is the gold standard for testing Malaria. PCR is the confirmatory test to rule out Dengue infection.

J Mitra & Co. is a pioneer in rapid and reliable diagnostic solutions for the last five decades. It’s the first Indian company to introduce Rapid Test Cards for vector-borne diseases. Malaria Antigen test kits have come to use with the ban on Antibody kits. All these products now have a leadership position in the market. ELISA kits for Dengue and Malaria have been the trendsetter for the market. Their performance has challenged the higher platforms even for transient infections. Recently, the company has introduced FIA testing for Dengue Quanti Cards (for NS1 , IgG , and IgM). These kits are at par with PCR tests.

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