Regional and Age-Related Variations in Blood Calcium Levels among Patients with Plasmodium falciparum and P. vivax malaria: A Systematic Review and Meta-Analysis
Issued Date
2023-11-01
Resource Type
eISSN
20726643
Scopus ID
2-s2.0-85176735800
Journal Title
Nutrients
Volume
15
Issue
21
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nutrients Vol.15 No.21 (2023)
Suggested Citation
Kotepui K.U., Mahittikorn A., Wilairatana P., Masangkay F.R., Kotepui M. Regional and Age-Related Variations in Blood Calcium Levels among Patients with Plasmodium falciparum and P. vivax malaria: A Systematic Review and Meta-Analysis. Nutrients Vol.15 No.21 (2023). doi:10.3390/nu15214522 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91160
Title
Regional and Age-Related Variations in Blood Calcium Levels among Patients with Plasmodium falciparum and P. vivax malaria: A Systematic Review and Meta-Analysis
Other Contributor(s)
Abstract
Despite several studies examining the relationship between calcium levels and malaria, inconsistencies and varied results remain in the literature. This study aimed to synthesize the evidence on the association between blood calcium levels and malaria severity. A systematic literature search was conducted in the Embase, Scopus, PubMed, Ovid, and Google Scholar databases. The studies that investigated calcium levels in participants with malaria were reviewed and included for synthesis. The quality of included studies was assessed based on a standardized checklist by the Joanna Briggs Institute (JBI) critical appraisal checklists. The thematic synthesis had been used for qualitative synthesis. For the quantitative synthesis, the meta-analysis was performed to estimate the pooled effect sizes for differences in calcium levels between groups of participants using a random effect model using Hedge’s g as a measure of effect size. Out of the 4574 identified records, 14 studies were reviewed. The thematic synthesis across these studies noted a consistent theme: reduced calcium levels in malaria patients compared to uninfected controls. However, the meta-analysis encompassing three specific analyses—comparing calcium levels between malaria patients and controls, severe and non-severe malaria cases, and fatal cases versus survivors—showed no significant difference in calcium levels. The statistics were as follows: (1) p = 0.15, Hedge’s g: −1.00, 95% CI: −2.37–0.38, I2: 98.97, 9 studies; (2) p = 0.35, Hedge’s g: −0.33, 95% CI: −1.02–0.36, I2: 81.61, 3 studies; and (3) p = 0.71, Hedge’s g: −0.14, 95% CI: −0.91–0.62, I2: 87.05, 3 studies. Subgroup analyses indicated that regional disparities, especially between Africa and Asia, and participant age groups may influence these outcomes. While a trend of decreased calcium levels in malaria patients was observed, the meta-analytical results suggest regional and age-related variations. Further investigations should emphasize these differences to better guide clinical management, prognostic applications, and the crafting of policies concerning malaria’s metabolic effects.