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Given the inconsistent findings regarding PT in malaria across different severities and between <jats:italic>Plasmodium falciparum<\/jats:italic> and <jats:italic>P. vivax<\/jats:italic>, 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 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01, Mean difference: 8.86\u00a0s, 95% CI 5.32\u201312.40\u00a0s, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>: 87.88%, 4 studies). Severe malaria cases also showed significantly higher PT than non-severe ones (<jats:italic>P<\/jats:italic>\u2009=\u20090.03, Hedges\u2019s g: 1.65, 95% CI 0.20\u20133.10, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>: 97.91%, 7 studies). No significant PT difference was observed between <jats:italic>P. falciparum<\/jats:italic> and <jats:italic>P. vivax<\/jats:italic> infections (<jats:italic>P<\/jats:italic>\u2009=\u20090.88, Mean difference: 0.06, 95% CI \u2212\u20090.691\u20130.8, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>: 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 <jats:italic>P. falciparum<\/jats:italic> and <jats:italic>P. vivax<\/jats:italic> 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.<\/jats:p>","DOI":"10.1038\/s41598-024-60170-y","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T10:03:33Z","timestamp":1714644213000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Alteration of prothrombin time in Plasmodium falciparum and Plasmodium vivax infections with different levels of severity: a systematic review and meta-analysis"],"prefix":"10.1038","volume":"14","author":[{"given":"Suriyan","family":"Sukati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tirawat","family":"Wannatung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thitinat","family":"Duangchan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwuntida Uthaisar","family":"Kotepui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Ramirez","family":"Masangkay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Ping","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manas","family":"Kotepui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"60170_CR1","unstructured":"WHO. 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