Impact of Malaria Severity on Selected Liver Function Markers in Aden, Yemen: A Pilot Study

الملخص

Background: Malaria remains a significant public health concern, with Plasmodium falciparum and P. vivax infections often leading to systemic complications, including hepatic dysfunction.

Objective: This study investigates the relationship between malaria severity and liver function abnormalities, particularly bilirubin and liver enzyme elevations, in malaria patients in Aden, Yemen.

Method: A retrospective observational study was conducted among 150 malaria patients from September to December 2024 in multiple private and public hospitals in Aden, Yemen. Malaria severity was classified based on WHO criteria into severe, moderate and mild. Liver function markers, including (ALT), (AST), (T. Bilirubin), and (D. Bilirubin), were measured using spectrophotometry. Statistical analyses were performed using SPSS version 26 with significance set at p < 0.05.

Results: Males (61%) were more affected than females (39%), with Plasmodium falciparum accounting for 68% of cases. Severe malaria was observed in 56% of patients. Liver enzyme levels were markedly elevated in severe malaria cases, with mean ALT at 80.29 ± 45.11 U/L and ALT at 78.46 ± 46.67 U/L. Bilirubin levels were also significantly increased (T. Bilirubin: 3.00 ± 2.3 mg/dL, D. Bilirubin: 1.19 ± 1.1 mg/dL), with a strong association between disease severity and hepatic dysfunction (p < 0.001). However, no statistical relationship was found between malaria severity and demographic characteristics, including gender (p = 0.318), place of residence (p = 0.438), and participant age (p = 0.869).

Conclusion: Severe malaria is associated with significant hepatic dysfunction, characterized by elevated liver enzyme levels and hyperbilirubinemia. These findings underscore the importance of continuous liver function monitoring in malaria patients to prevent severe hepatic complications. Further research is needed to elucidate the underlying mechanisms and potential long-term impacts of malarial hepatopathy.