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Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis

Author

Listed:
  • Aongart Mahittikorn

    (Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
    These authors contributed equally to this work.)

  • Kwuntida Uthaisar Kotepui

    (Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand)

  • Wanida Mala

    (Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand)

  • Polrat Wilairatana

    (Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand)

  • Manas Kotepui

    (Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
    These authors contributed equally to this work.)

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, I 2 : 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, I 2 : 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, I 2 : 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.

Suggested Citation

  • Aongart Mahittikorn & Kwuntida Uthaisar Kotepui & Wanida Mala & Polrat Wilairatana & Manas Kotepui, 2022. "Procalcitonin as a Candidate Biomarker for Malarial Infection and Severe Malaria: A Meta-Analysis," IJERPH, MDPI, vol. 19(18), pages 1-15, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:18:p:11389-:d:911547
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    References listed on IDEAS

    as
    1. Manas Kotepui & Kwuntida Uthaisar Kotepui & Giovanni D Milanez & Frederick R Masangkay, 2020. "Severity and mortality of severe Plasmodium ovale infection: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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