Evaluation of C-reactive protein as a biochemical marker for assessing disease severity in Malaria

Levels of C-reactive protein , a well characterised serum acute phase protein were measured in a total of 32 patients admitted to JK hospital with the diagnosis of Malaria (18 vivax malaria and 14 falciparum malaria) . Serum C-reactive protein concentrations were measured daily in all the patients over a seven day period .Percentage parasitemia , platelet count , serum bilirubin , alanine aminotransferase and aspartate aminotransferase levels were measured initially on the day of admission . Though Serum C-reactive protein concentration was significantly elevated in all the malaria patients , it was significantly higher (P<0.01) in Plasmodium falciparum(29.4±10.9 mg/L ) as compared to P. Vivax malaria(14.5± 3.7mg/L ) . The highest concentration was observed on day 2 ( Plasmodium falciparum :65.3±16.8 mg/L ; Plasmodium vivax: 27.1±13.0 mg/L )and fell significantly between day 1 and day 7 in parallel with clinical recovery. A significant positive correlation was found between serum CRP and conventional laboratory markers of severity of malaria like percentage parasitemia , serum bilirubin, serum concentrations of alanine aminotransferase and aspartate aminotransferase in Plasmodium falciparum patients but not in Plasmodium Vivax.These results suggest that C-reactive protein can be used as a biomarker for assessing disease severity particularly in Plasmodium falciparum malaria.