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| The Role of TNF-? Levels as Predictive Diagnostic Biomarker Among Children with Severe Falciparum Malaria in Endemic Area in Sudan |
Khalid Abdelsamea Mohamedahmed, Adam Dawoud Abakar, Mona Omer Ahmed, Muawia Mohammed Mukhtar, Bakri Yousif Mohammed Nour
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Abstract:
Tumor necrosis factor alpha (TNF-?) level is a central proinflammatory cytokine. Their production associated with severe falciparum malaria. The purpose of this study was to compare TNF-? levels between severe falciparum malaria, uncomplicated malaria and control. Furthermore to evaluate the association between TNF-? levels and malaria parasitemia and malaria parasite count. A case control hospital based study was included 300 Sudanese children (100 severe falciparum malaria (with mean age 8.63 ± 3.40 years; 61% male; 39% female), 100 uncomplicated falciparum malaria (with mean age 8.83 ± 4.20 years; 45% male; 55% female) and 100 normal healthy children controls (with mean age 10.08 ± 3.58 years; 50% male; 50% female). The malaria parasitemia was estimated using thick blood film, while parasite count was counted using thin blood film. TNF-? levels measured using Human TNF-? ELISA MAX™ Deluxe Sets - BioLegend, Inc. The data were analyzed using SPSS software (V 20.0) and Statdisk software (V 13.0). The average of TNF-? levels were markedly elevated in serum of severe and uncomplicated falciparum malaria (200.98 ± 92.77 and 112.42 ± 35.52 pg/ml respectively) versus normal healthy children controls (38.81 ± 22.23 pg/ml), giving statistically highly significant difference (P value = 0.000). Furthermore, the levels of TNF-? in malaria parasitemia had statistically highly significant differences and significant positive correlation (P value = 0.000 for both). On the other hand, the levels of TNF-? had significant positive correlation within parasite count (P value = 0.000). This study showed that TNF-? levels had association with falciparum malaria severity, and level of parasitemia. The results obtained in this study will help clinicians to diagnose and to improve the management of severe malaria cases.
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