Abstract

Introduction: Malaria is a major public health challenge causing a high morbidity and mortality worldwide. In plasmodium falciparum infection, determination of C-reactive protein (CRP) levels may enable quicker assessment of the overall burden of malaria severity. This study was conducted to investigate the relationship between CRP level and severity of plasmodium falciparum malaria in patients admitted at Al-Gamhouria Modern General Hospital in Aden, Yemen.

Methods: This is a cross-sectional study included 60 patients diagnosed with plasmodium falciparum malaria for the period from June 1st to Oct. 31st, 2024; and 30 healthy individuals as a control group for C-reactive protein level. Baseline and laboratory data were collected and analyzed statistically, then related to the severity of malaria. 

Results: Fifty five percent of the included patients with plasmodium falciparum malaria were males, with a mean age of 34.1± 11.1 years, and mean body mass index of 22.7±2.6 kg/m². The median erythrocytes sedimentation rate (ESR) was 41.0 mm/hr, the median parasite density was 6660 parasites/µL, and the median percentage of parasitemia was 8%. The median CRP was significantly higher among malaria patients than in the control group (50.7 vs. 2.1 mg/L) (p: 0.001). According to the World Health Organization (WHO) criteria for severe malaria, 23.3% had severe plasmodium falciparum malaria. Severity of plasmodium falciparum malaria was significantly related to lower median hemoglobin concentration, higher median total white blood cells (WBCs) count, and higher median CRP (p<0.05). The percentage of parasitemia showed significant negative correlation to hemoglobin concentration (r: -0.299), red blood cells (RBCs) count (r: -0.302), and the percentage of eosinophils (r: -0.267), in addition to significant positive correlations to the red cell distribution width (RDW) (r: 0.279), total WBCs (r: 0.607), parasites density (r: 0.779), and CRP level (r: 0.583).

Conclusion: This study concluded that CRP level can be used to assess the severity of malaria. Elevated CRP level could be helpful in early prediction of the disease severity in patients infected with Plasmodium falciparum malaria.

Keywords: Plasmodium falciparum, Malaria, CRP, Parasitemia, Severity.

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