Antibody against a ring-infected erythrocyte surface antigen in cerebral and non-cerebral malaria patients

An indirect fluorescent antibody test for glutaraldehyde-fixed, ring-infected erythrocyte surface antigen was performed on admission sera from 45 patients with complicated cerebral Plasmodium falciparum malaria, 33 with uncomplicated cerebral malaria, 91 non-cerebral malaria patients, and 53 blood donors from a non-malarious area. 14 (31%), 28 (85%), 64 (70%), and 1 (2%), respectively, had titres greater than or equal to 1/25, considered as positive. The seropositive rate and the geometric mean reciprocal titre of patients with complicated cerebral malaria were significantly lower than those of uncomplicated and non-cerebral patients, particularly in the 6-14 and 15-29 year age groups. Compared with non-cerebral patients, lower seropositive rates for patients with complicated cerebral malaria were demonstrated only in those who had been ill 4 or more days before admission; whereas lower rates for patients with complications, when compared with rates in those with uncomplicated cerebral malaria, occurred irrespective of the duration of illness.