Evidence of a major reservoir of non-malarial febrile diseases in malaria-endemic regions of Bangladesh

Abstract

In malaria-endemic regions any febrile case is likely to be classified as malaria based on presumptive diagnosis largely caused by a lack of diagnostic resources. A district-wide prevalence study assessing etiologies of fever in 659 patients recruited in rural and semi-urban areas of Bandarban district in southeastern Bangladesh revealed high proportions of seropositivity for selected infectious diseases (leptospirosis, typhoid fever) potentially being misdiagnosed as malaria because of similarities in the clinical presentation. In an area with point prevalences of more than 40% for malaria among fever cases, even higher seroprevalence rates of leptospirosis and typhoid fever provide evidence of a major persistent reservoir of these pathogens.

Figure 1.

Flow chart for enrollment and sampling including demographic characteristics for community and hospital survey.

Figure 2.

Test positivity of malaria, leptospirosis, typhoid fever, and dengue by age group and gender. In the age group 0–7 years only malaria diagnosis was performed.