TUMOR-NECROSIS-FACTOR IN FALCIPARUM-MALARIA

To investigate the relationship of TNF alpha levels to Plasmodium falc iparum (PF) infection, plasma TNF alpha concentrations were measured i n Pakistani adults and children with mild, severe, cerebral and chroni c falciparum malaria and healthy (control) subjects. The initial geome tric mean plasma concentrations of TNF alpha in adult patients with se vere malaria (187.6 pg/mL) were significantly higher than mild malaria patients (87.1 pg/mL, P < 0.001). TNF alpha levels were not correlate d to parasite density, cerebral malaria, young age, hypoglycemia or fa tal outcome; however, they were associated with severe anemia, and hep atic and kidney dysfunction. TNF alpha levels were not significantly i ncreased in 16 patients with hyperparasitemia and were significantly e levated (P < 0.02) in chronic malaria patients as compared to control subjects. TNF alpha levels were elevated independently in patients wit h 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.