Tumor necrosis factor in falciparum malaria

ABSTRACT

To investigate the relationship of TNF alpha levels to Plasmodium falciparum [PF] infection, plasma TNF alpha concentrations were measured in Pakistani adults and children with mild, severe, cerebral and chronic falciparum malaria and healthy [control] subjects. The initial geometric mean plasma concentrations of TNF alpha in adult patients with severe malaria [187.6 pg/mL] were significantly higher than mild malaria patients [87.1 pg/mL, P < 0.001]. TNF alpha levels were not correlated to parasite density, cerebral malaria, young age, hypoglycemia or fatal outcome; however, they were associated with severe anemia, and hepatic and kidney dysfunction. TNF alpha levels were not significantly increased in 16 patients with hyperparasitemia and were significantly elevated [P < 0.02] in chronic malaria patients as compared to control subjects. TNF alpha levels were elevated independently in patients with anemia, hypoglycemia [P < 0.001, P < 0.05], and hepatic and kidney [P < 0.001 each] dysfunction. In this study, high TNF alpha levels were associated with several manifestations of severe malaria and were not specific to cerebral malaria and hyperparasitemia