Malaria is one of the world’s deadliest diseases affecting people, particularly in tropical and sub-tropical regions of the world. Malaria remains the most complex and overwhelming health problem facing humanity [1]. About 300 to 500 million cases and 2 to 3 million deaths occur per year. The disease imposes serious effect on the blood resulting in the haemolysis of red blood cells. Immune mediated haemolysis is thought to occur in some diseases [2,3]. Adherence of complement component C3 and C4 and sensitization with IgG is often associated with a positive direct Coombs test in malaria infection [4]. Association between a high incidence of DAT positivity and P. falciparum parasitaemia associated with raised serum antibody titres to falciparum schizonts has been suggested [5]. A previous report of DAT testing performed on 243 malaria parasitized children in Kenya indicated that 70% had their RBCs coated with IgG, C3 and C4 either separately or together [6]. Severe anaemia and intravascular haemolysis with characteristic positive direct Coombs test are associated with severe forms of Plasmodium falciparum malaria [7]. Complement factors have been implicated in the mechanism leading to excess anaemia in acute P. falciparum infection [8]. Cases of three patients with malaria who developed post malaria immune mediated haemolysis has been reported [9]
The DAT test was introduced by Coombs [10] in 1945. It can detect the presence of immunoglobulins or complement, in particular IgG and C3d, attached to red cell membranes [11]. Sokoto State in North Western, Nigeria is an area hyperendemic for P. falciparum malaria. There is paucity of data on DAT in P. falciparum parasitized individuals in Nigeria. The aim of this study was to investigate the incidence of positive DAT results among 100 patients with P. falciparum malaria in Sokoto, North Western Nigeria.