Tumour necrosis factor-α as a prognostic biomarker of severe malaria: a systematic review and meta-analysis
Issued Date
2022-05-01
Resource Type
ISSN
11951982
eISSN
17088305
Scopus ID
2-s2.0-85134434650
Pubmed ID
35467747
Journal Title
Journal of Travel Medicine
Volume
29
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Travel Medicine Vol.29 No.4 (2022)
Suggested Citation
Mahittikorn A., Mala W., Srisuphanunt M., Masangkay F.R., Kotepui K.U., Wilairatana P., Kotepui M. Tumour necrosis factor-α as a prognostic biomarker of severe malaria: a systematic review and meta-analysis. Journal of Travel Medicine Vol.29 No.4 (2022). doi:10.1093/jtm/taac053 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85878
Title
Tumour necrosis factor-α as a prognostic biomarker of severe malaria: a systematic review and meta-analysis
Other Contributor(s)
Abstract
Background: Tumour necrosis factor-alpha (TNF-α) levels are reportedly altered during malaria. In this systematic review and meta-analysis, we aimed to collect and compare data on TNF-α levels between patients with malaria of varying severity and healthy asymptomatic positive controls. Methods: We searched PubMed, Scopus and Web of Science for studies that reported TNF-α levels in malaria cases of different severity and healthy asymptomatic positive controls using a combination of search terms. The quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. To compare the TNF-α levels among fatal cases, severe cases, uncomplicated cases and healthy asymptomatic positive controls, we applied the random-effects model that assumed the existence of variations between studies. The effect estimate was pooled mean difference (MD) with a 95% confidence interval (CI). Results: From 1694 studies, we included 31 studies that met our eligibility criteria for systematic review and meta-analysis. Patients with severe malaria showed higher mean TNF-α levels than those with uncomplicated malaria (P < 0.001, pooled MD = 79.02 pg/ml, 95% CI: 63.68-94.35 pg/ml, I2: 99.5%, n = 26 studies). Furthermore, fatal cases had no difference in the mean TNF-α levels in comparison with survived cases (P = 0.055, pooled MD = 82.38 pg/ml, 95% CI: -1.93 to 166.69 pg/ml, I2: 99.54%, n = 5 studies). Finally, patients with uncomplicated malaria showed higher mean TNF-α levels than those with asymptomatic malaria (P < 0.001, pooled MD = 45.10 pg/ml, 95% CI: 18.45-71.76 pg/ml, I2: 97.09%, n = 5 studies). Conclusion: This systematic review and meta-analysis confirmed the increase of TNF-α levels in patients with severe malaria. Therefore, TNF-α may be alternatively used as a prognostic biomarker of severe malaria. Trial registration: Not applicable.