Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis
Issued Date
2022-09-01
Resource Type
ISSN
16617827
eISSN
16604601
Scopus ID
2-s2.0-85138360508
Pubmed ID
36141662
Journal Title
International Journal of Environmental Research and Public Health
Volume
19
Issue
18
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Environmental Research and Public Health Vol.19 No.18 (2022)
Suggested Citation
Mahittikorn A., Kotepui K.U., Mala W., Wilairatana P., Kotepui M. Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis. International Journal of Environmental Research and Public Health Vol.19 No.18 (2022). doi:10.3390/ijerph191811389 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87252
Title
Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis
Author's Affiliation
Other Contributor(s)
Abstract
Procalcitonin (PCT), as a marker of malaria severity, remains to be investigated. The present study collated and compared the levels of PCT between patients with severe malaria, uncomplicated malaria, and control participants to assess their role in predicting malaria infection and disease severity. The systematic review was registered at PROSPERO with registration number CRD42021297243. The search for relevant studies that reported PCT in patients with malaria was performed in PubMed, Scopus, and Web of Science. The following meta-analyses were conducted; (1) the pooled mean PCT levels in patients with severe and uncomplicated malaria, and (2) the pooled mean difference in PCT levels between patients with severe and uncomplicated malaria. Fifteen studies were included for qualitative and quantitative syntheses. The meta-analysis results show that the pooled mean PCT levels in patients with uncomplicated malaria were 3.92 ng/mL (95% CI: 2.26–5.58 ng/mL, I2: 96.5, five studies), whereas the pooled mean PCT levels in patients with severe malaria were 14.13 ng/mL (95% CI: 8.75–19.5 ng/mL, I2: 92.6, six studies). The meta-analysis showed that patients with severe malaria had an equal mean of PCT compared to those with uncomplicated malaria when the random-effects model was used (p: 0.055, weighted mean difference: 6.93, 95% CI: −0.16–14.02, I2: 84.6%, four studies). There were probable correlations between the level of parasitemia, immunity level, and possibly bacterial or other parasitic co-infection that could affect the PCT level among different clinical severities of malaria. Therefore, the PCT level alone does not seem to be a suitable biomarker to discriminate the severe/uncomplicated or infected/uninfected cases. Further studies should investigate the increased PCT levels in combination with other markers in association with malaria infection and severity.