Whereas presumptive treatment with chloroquine in cases of fever is well accepted, sometimes, doctors indulge in presumptive treatment with newer drugs, reserved for multi drug resistance falciparum malaria, even if the MP test is repeatedly negative. Most often such cases turn out to be non-malarial fevers. Underdiagnosis -forgetting malaria 1. Malaria may not be considered as a possibility in places where it is not common-history of travel to malarious area should be elicited. It may not be considered in patients on chemoprophylaxis for malaria.
Malaria can always co-exist with other infections in an endemic area.
Therefore, it should be considered even in patients with other obvious infections causing fever. Misreport False positive Artifacts may be read as malarial parasites on peripheral smear as well as QBC test. Dirty slides, contaminated stains, inexperienced microscopist, recycled QBC tubes may be the causes. False negative Malarial parasites may be missed and the test reported as negative. Misjudgement of severity Overestimation Panic reaction to P. falciparum malaria is common among patients and not uncommon among doctors, resulting in overreaction to the situation and overtreatment.