Assessment of Inflammatory Markers Across Varying Malaria Parasite Densities in Patients at Rivers State University Teaching Hospital, Port Harcourt

Abstract

Aim: to assess the levels of some inflammatory markers in malaria parasite-infected subjects attending Rivers State University Teaching Hospital, Port Harcourt, Nigeria. Study Design:  Cross-sectional study. Place and Duration of Study: Rivers State University Teaching Hospital and Pamel Laboratories & Diagnostics Limited, both in Port Harcourt, between July 2023 and July 2024. Methodology: A total of 150 individuals were initially screened for various health conditions, resulting in 89 subjects deemed suitable for the study. This group comprised 43 males and 46 females, with 29 participants serving as controls and 60 participants as malaria-positive subjects. Blood specimens were obtained from each subject, and serum samples were extracted after centrifugation. These serum samples were used to assay IL-6, TNF-α using the ELISA method. Additionally, subjects were categorized based on parasitaemia severity and malaria treatment history. Data was analyzed using GraphPad Prism version 9.02. Descriptive statistics involving the use of Mean and Standard Deviation. Inferential Statistics involving the use of one-way ANOVA (PostHoc: Tukey’s multiple comparison test), students statistical t-test, and Pearson’s correlation. Statistical significance was set at p < 0.05. Results: The study found no significant differences in IL-6 (p=0.8878), TNF-α (0.0961), levels between control and malaria-positive subjects. However, based on malaria severity, there were no significant differences in TNF-α (p=0.1993) levels among mild, moderate, and high parasitaemia cases. However, IL-6 (p=0.0002) levels were elevated in high parasitaemia cases. Malaria treatment normalized all markers within 1-8 months, except IL-6 (p=0.0423), which remained significantly elevated in subjects with a history of malaria within 9-12 months. These results suggest that malaria parasitaemia does not significantly alter inflammatory markers such as IL-6 and TNF-α. The severity of parasitaemia influences IL-6, while malaria treatment typically returns most markers to baseline within 8 months, except for IL-6. Conclusion: Further research studies need to explore the mechanisms behind persistent IL-6 elevation post-malaria treatment and the potential long-term effects of other inflammatory markers in malaria patients.