The spectrum of clinical biomarkers in severe malaria and new avenues for exploration

Globally, malaria is a public health concern, with severe malaria (SM) contributing a major share of the disease burden in malaria endemic countries. In this context, identification and validation of SM biomarkers are essential in clinical practice. Some biomarkers (C-reactive protein, angiopoietin...

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Bibliographic Details
Published in:Virulence 2022-12, Vol.13 (1), p.634-653
Main Authors: Foko, Loick Pradel Kojom, Narang, Geetika, Tamang, Suman, Hawadak, Joseph, Jakhan, Jahnvi, Sharma, Amit, Singh, Vineeta
Format: Article
Language:English
Subjects:
Biomarkers
clinical infections
COVID-19
diagnostic
Humans
Malaria
Malaria, Falciparum
Pandemics
Plasmodium falciparum
Plasmodium vivax
prognostic biomarkers
Review
Reviews
Severe malaria
therapeutic
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Summary:Globally, malaria is a public health concern, with severe malaria (SM) contributing a major share of the disease burden in malaria endemic countries. In this context, identification and validation of SM biomarkers are essential in clinical practice. Some biomarkers (C-reactive protein, angiopoietin 2, angiopoietin-2/1 ratio, platelet count, histidine-rich protein 2) have yielded interesting results in the prognosis of Plasmodium falciparum severe malaria, but for severe P. vivax and P. knowlesi malaria, similar evidence is missing. The validation of these biomarkers is hindered by several factors such as low sample size, paucity of evidence-evaluating studies, suboptimal values of sensitivity/specificity, poor clinical practicality of measurement methods, mixed Plasmodium infections, and good clinical value of the biomarkers for concurrent infections (pneumonia and current COVID-19 pandemic). Most of these biomarkers are non-specific to pathogens as they are related to host response and hence should be regarded as prognostic/predictive biomarkers that complement but do not replace pathogen biomarkers for clinical evaluation of SM patients. This review highlights the importance of research on diagnostic/predictive/therapeutic biomarkers, neglected malaria species, and clinical practicality of measurement methods in future studies. Finally, the importance of omics technologies for faster identification/validation of SM biomarkers is also included.
ISSN:2150-5594
2150-5608
2150-5608
DOI:10.1080/21505594.2022.2056966