TY - JOUR
T1 - Alteration of prothrombin time in Plasmodium falciparum and Plasmodium vivax infections with different levels of severity
T2 - a systematic review and meta-analysis
AU - Sukati, Suriyan
AU - Wannatung, Tirawat
AU - Duangchan, Thitinat
AU - Kotepui, Kwuntida Uthaisar
AU - Masangkay, Frederick Ramirez
AU - Tseng, Ching Ping
AU - Kotepui, Manas
N1 - © 2024. The Author(s).
PY - 2024/5/2
Y1 - 2024/5/2
N2 - Malaria infection leads to hematological abnormalities, including deranged prothrombin time (PT). Given the inconsistent findings regarding PT in malaria across different severities and between Plasmodium falciparum and P. vivax, this study aimed to synthesize available evidence on PT variations in clinical malaria. A systematic literature search was performed in PubMed, Embase, Scopus, Ovid, and Medline from 27 November 2021 to 2 March 2023 to obtain studies documenting PT in malaria. Study quality was evaluated using the Joanna Briggs Institute checklist, with data synthesized through both qualitative and quantitative methods, including meta-regression and subgroup analyses, to explore heterogeneity and publication bias. From 2767 articles, 21 studies were included. Most studies reported prolonged or increased PT in malaria patients compared to controls, a finding substantiated by the meta-analysis (P < 0.01, Mean difference: 8.86 s, 95% CI 5.32-12.40 s, I
2: 87.88%, 4 studies). Severe malaria cases also showed significantly higher PT than non-severe ones (P = 0.03, Hedges's g: 1.65, 95% CI 0.20-3.10, I
2: 97.91%, 7 studies). No significant PT difference was observed between P. falciparum and P. vivax infections (P = 0.88, Mean difference: 0.06, 95% CI - 0.691-0.8, I
2: 65.09%, 2 studies). The relationship between PT and malaria-related mortality remains unclear, underscoring the need for further studies. PT is typically prolonged or increased in malaria, particularly in severe cases, with no notable difference between P. falciparum and P. vivax infections. The inconsistency in PT findings between fatal and non-fatal cases highlights a gap in current understanding, emphasizing the need for future studies to inform therapeutic strategies.
AB - Malaria infection leads to hematological abnormalities, including deranged prothrombin time (PT). Given the inconsistent findings regarding PT in malaria across different severities and between Plasmodium falciparum and P. vivax, this study aimed to synthesize available evidence on PT variations in clinical malaria. A systematic literature search was performed in PubMed, Embase, Scopus, Ovid, and Medline from 27 November 2021 to 2 March 2023 to obtain studies documenting PT in malaria. Study quality was evaluated using the Joanna Briggs Institute checklist, with data synthesized through both qualitative and quantitative methods, including meta-regression and subgroup analyses, to explore heterogeneity and publication bias. From 2767 articles, 21 studies were included. Most studies reported prolonged or increased PT in malaria patients compared to controls, a finding substantiated by the meta-analysis (P < 0.01, Mean difference: 8.86 s, 95% CI 5.32-12.40 s, I
2: 87.88%, 4 studies). Severe malaria cases also showed significantly higher PT than non-severe ones (P = 0.03, Hedges's g: 1.65, 95% CI 0.20-3.10, I
2: 97.91%, 7 studies). No significant PT difference was observed between P. falciparum and P. vivax infections (P = 0.88, Mean difference: 0.06, 95% CI - 0.691-0.8, I
2: 65.09%, 2 studies). The relationship between PT and malaria-related mortality remains unclear, underscoring the need for further studies. PT is typically prolonged or increased in malaria, particularly in severe cases, with no notable difference between P. falciparum and P. vivax infections. The inconsistency in PT findings between fatal and non-fatal cases highlights a gap in current understanding, emphasizing the need for future studies to inform therapeutic strategies.
KW - Coagulation
KW - Malaria
KW - Plasmodium
KW - Prothrombin time
KW - PT
KW - Severity
KW - Severity of Illness Index
KW - Malaria, Falciparum/parasitology
KW - Humans
KW - Prothrombin Time
KW - Malaria, Vivax/parasitology
KW - Plasmodium falciparum
KW - Plasmodium vivax/pathogenicity
UR - http://www.scopus.com/inward/record.url?scp=85191957760&partnerID=8YFLogxK
U2 - 10.1038/s41598-024-60170-y
DO - 10.1038/s41598-024-60170-y
M3 - 文章
C2 - 38698102
AN - SCOPUS:85191957760
SN - 2045-2322
VL - 14
SP - 9816
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 9816
ER -