Interpretation of low-level Plasmodium infection rates determined by ELISA for anophelines (Diptera: Culicidae) from Egyptian oases.

Plasmodium infection rates determined by enzyme-linked immunosorbent assay (ELISA) were compared for Anopheles sergentii (Theobald) and An. multicolor Cambouliu in Siwa Oasis, Egypt, an area with low-level Plasmodium vivax transmission, and in Bahariya and Farafra, two other Egyptian oases which appear to be free of malaria. Initial testing indicated that 4.4% (23 of 518) and 0.8% (4 of 518) of the An. sergentii were positive for P. vivax and P. falciparum, respectively, and that 1.4% (1 of 71) of the An. multicolor were positive for P. falciparum. However, after two confirmational tests, only 1.2% (6 of 518) of the An. sergentii remained consistently positive for P. vivax. Initial ELISA absorbance was not a useful predictor of potential false positive reactions in the P. vivax assay. Paradoxically, the six ELISA-positive An. sergentii were from the two malaria-free oases. This study raises the question of whether ELISA-positive reactions for anopheline vector species provides unequivocal evidence for transmission in areas of low malaria endemicity.