Analysis of the relationship between malaria and inflammatory biomarker levels in children in rural Iraq: Impact of nutritional deficiencies, anemia, and hematological disorders.
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BACKGROUND: Malaria remains a significant public health challenge in rural Iraq, particularly among children who are vulnerable due to poor nutrition and limited healthcare access. The aim of the study was to investigate the relationship between malaria and inflammatory biomarker levels in children, with a focus on the impact of nutritional deficiencies, anemia, and hematological disorders on disease progression and severity. METHODOLOGY: This case-control study (August 2023-February 2025) included 150 children with malaria and 50 controls aged 5-8 years in rural Iraq. Ethical approval and parental consent were obtained. Blood samples were collected in gel and EDTA tubes, processed, and stored at -80°C. C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured through the enzyme-linked immunosorbent assay, while hemoglobin was measured via complete blood count. Linear device, while iron, zinc, vitamin D, and ferritin were analyzed using the Cobas e411. RESULTS: The study showed significant differences in inflammatory markers between the malaria and control groups. CRP (18.4 vs. 5.2 mg/L; P < 0.001), IL-6 (10.2 vs. 3.1 pg/mL; P < 0.001), and TNF-α (12.5 vs. 4.0 pg/mL; P < 0.001) were elevated in malaria patients. Hemoglobin (9.8 vs. 12.5 g/dL; P < 0.001) and iron levels (45.3 vs. 90.2 μg/dL; P < 0.001) were lower, while ferritin levels were higher (30.0 vs. 100.0 ng/mL; P < 0.001). Malnutrition was more prevalent in the malaria group (65% vs. 15%; P < 0.001), as were anemia (70% vs. 20%; P < 0.001) and blood disorders (40% vs. 10%; P < 0.001). Zinc and vitamin D levels were also significantly reduced in malaria patients (P < 0.001). CONCLUSION: This study reveals that malaria profoundly affects inflammation, nutrition, and blood health, with elevated CRP, IL-6, and TNF-α levels, common anemia, and disrupted iron metabolism. Zinc and vitamin D deficiencies were frequent. About 65% had severe malnutrition, 70% anemia, and 40% other blood disorders. Findings stress integrated nutritional and anti-inflammatory care and call for further biomarker research.