Malaria is the most important of the parasitic diseases of humans with transmission in more than 100 countries, affecting more than 1 billion people and causing 1- 3 million deaths each year. It is a major cause of morbidity and mortality in tropical regions. Plasmodiurn falciparum infection is a prime cause of concern in India where a resurgence of infection is being witnessed in the present decade. The state for Orissa with a population of 4% that of India, accounts for 25% of all cases of malaria .Orissa also bears the highest mortality rate of 35% of total malaria deaths in the country. Cerebral malaria is the most dreaded form of malaria, carrying a mortality rate of 50% even in treated patients. The SPR (Slide positivity rate) in Orissa is 11.89% of which 84% are pl. falciparum and death rate is 35% of the total mortality in the country. WHO has fixed a goal to reduce malarial mortality by 50% by 2010.
Fever is a common presentation of patients in developing countries like India and most of which are of infectious etiology. Thus malaria is one of the leading causes. The clinical profile of falciparum malaria involves hepatic, renal, circulatory, respiratory and cerebral features . There are several clinical and biochemical parameters, which have been claimed to predict outcome with reasonable degree of accuracy. Among them TNF- α in falciparum malaria mediate different biochemical changes.
In the past, changes in lipid profile have been observed in malaria (Vernes et al, 1980, Nissen - Ehle et al, 1990, Parola P et al 2004). Most of the time it is not possible to ascertain the etiologic agent in a case of pyrexia, as malaria parasites are difficult to be found out in blood . Hence the above mentioned acute phase reactants mediated changes in lipid profile may be considered as an indirect evidence of infection by different etiologic agents. As it is difficult and costlier affair to measure TNF - α and other acute phase reactants and lipid profile measurement is a cheap and widely available alternative, its estimation may be useful in diagnosing, differentiating or predicting outcomes in malaria.