{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:00:00Z","timestamp":1790067600235,"version":"4.0.1"},"reference-count":58,"publisher":"SAGE Publications","issue":"7-9","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antioxidants &amp; Redox Signaling"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      It is still unclear how ascorbic acid levels relate to the pathogenesis of malaria. This systematic review synthesized different ascorbic acid levels in malaria patients with different severity levels of malaria and\n                      <jats:italic toggle=\"yes\">Plasmodium<\/jats:italic>\n                      species.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The systematic review protocol was registered in the PROSPERO database (CRD42023394849). A systematic search of PubMed, Embase, MEDLINE, Ovid, Scopus, and Google Scholar was conducted to identify studies that reported ascorbic acid and malaria. The pooled standardized mean difference (Cohen's\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      ) with 95% confidence intervals (CIs) was calculated using the random-effects model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 1480 articles were obtained from the searches of the databases, and 30 studies were included for syntheses. The meta-analysis revealed that patients with malaria had lower levels of ascorbic acid than those without malaria or uninfected controls (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01, Cohen's\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      \u2009=\u2009\u22123.71, 95% CI\u2009=\u2009\u22124.44 to \u22122.98,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998.87%, 30 studies). Comparable levels of ascorbic acid were observed between patients with severe malaria and those with nonsevere malaria (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.06, Cohen's\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      \u2009=\u2009\u22121.39, 95% CI\u2009=\u2009\u22122.85 to 0.07,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200996.58%, 4 studies). Similarly, levels of ascorbic acid were comparable between patients with\n                      <jats:italic toggle=\"yes\">Plasmodium falciparum<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Plasmodium vivax<\/jats:italic>\n                      malaria (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.34, Cohen's\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      \u2009=\u2009\u22121.06, 95% CI\u2009=\u2009\u22123.23 to 1.12,\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200997.30%, 3 studies).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The meta-analysis reveals diminished levels of ascorbic acid in malaria cases. Manipulating the host's nutritional status, such as by supplementing it with ascorbic acid to restore reactive oxygen species balance, may alter the progression of malarial infection and prevention of disease severity.\n                      <jats:italic toggle=\"yes\">Antioxid. Redox Signal.<\/jats:italic>\n                      40, 460\u2013469.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/ars.2023.0306","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T02:44:45Z","timestamp":1687229085000},"page":"460-469","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Malaria Is Associated with Diminished Levels of Ascorbic Acid: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9172-3615","authenticated-orcid":false,"given":"Manas","family":"Kotepui","sequence":"first","affiliation":[{"name":"Medical Technology, School of Allied Health Sciences, Walailak University, Thai Buri, Nakhon Si Thammarat, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aongart","family":"Mahittikorn","sequence":"additional","affiliation":[{"name":"Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nsoh Godwin","family":"Anabire","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana."},{"name":"West African Centre for Cell Biology of Infectious Pathogens (WACCBIP); Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Ramirez","family":"Masangkay","sequence":"additional","affiliation":[{"name":"Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwuntida Uthaisar","family":"Kotepui","sequence":"additional","affiliation":[{"name":"Medical Technology, School of Allied Health Sciences, Walailak University, Thai Buri, Nakhon Si Thammarat, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.23937\/2643-461X\/1710053"},{"key":"e_1_3_5_3_1","unstructured":"Abdullah M Jamil RT Attia FN. Vitamin C (Ascorbic Acid). StatPearls: Treasure Island FL; 2022."},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.37796\/2211-8039.1010"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.4314\/ajid.v10i1.3"},{"key":"e_1_3_5_6_1","first-page":"259","article-title":"Antioxidant vitamin levels among preschool children with uncomplicated Plasmodium falciparum malaria in Sokoto, Nigeria","volume":"6","author":"Aghedo FI","year":"2013","unstructured":"Aghedo FI, , Shehu RA, , Umar RA, et al. Antioxidant vitamin levels among preschool children with uncomplicated Plasmodium falciparum malaria in Sokoto, Nigeria. J Multidiscip Healthc, 2013; 6:259\u2013263.","journal-title":"J Multidiscip Healthc"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmedt.2022.1068972"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2019.04.033"},{"key":"e_1_3_5_9_1","first-page":"523","article-title":"Serum levels of micronutrients and antioxidants during malaria in pregnant women in Ado-Ekiti, Ekiti state, Nigeria","volume":"1","author":"Asaolu MF","year":"2009","unstructured":"Asaolu MF, , Igbaakin PA. Serum levels of micronutrients and antioxidants during malaria in pregnant women in Ado-Ekiti, Ekiti state, Nigeria. Int J Med Med Sci, 2009; 1:523\u2013526.","journal-title":"Int J Med Med Sci"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2003.09.011"},{"key":"e_1_3_5_11_1","unstructured":"Buck E Finnigan NA. Malaria. StatPearls: Treasure Island FL; 2022."},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2007.07.002"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-5-85"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(99)90180-3"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/64.1.94"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2015.09.002"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42452-020-04063-5"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.5897\/AJB2004.000-2110"},{"key":"e_1_3_5_19_1","first-page":"53","article-title":"Serum level of antioxidant vitamins (vitamin A, C and E) in Plasmodium falciparum malaria infected children in Owerri, eastern Nigeria","volume":"21","author":"Ekeanyanwu RC","year":"2009","unstructured":"Ekeanyanwu RC, , Achuka N, , Akpoilih BU. Serum level of antioxidant vitamins (vitamin A, C and E) in Plasmodium falciparum malaria infected children in Owerri, eastern Nigeria. Biokemistri, 2009; 21:53\u201358.","journal-title":"Biokemistri"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9120(97)00119-7"},{"key":"e_1_3_5_21_1","first-page":"1","article-title":"Serum ascorbic acid levels among children of African descent with acute Plasmodium falciparum malaria in Sokoto, north western Nigeria","volume":"2","author":"Erhabor O","year":"2008","unstructured":"Erhabor O, , Orighomisan O, , Erhabor T, et al. Serum ascorbic acid levels among children of African descent with acute Plasmodium falciparum malaria in Sokoto, north western Nigeria. SF Obstet Women Health J, 2008; 2:1\u20137.","journal-title":"SF Obstet Women Health J"},{"key":"e_1_3_5_22_1","first-page":"00131","article-title":"Changes in levels of antioxidant markers and status of some enzyme activities among falciparum malaria patients in Yemen","volume":"4","author":"Ezzi AAA","year":"2017","unstructured":"Ezzi AAA, , Al Salahy MB, , Shnawa BH, et al. Changes in levels of antioxidant markers and status of some enzyme activities among falciparum malaria patients in Yemen. J Microbiol Exp, 2017; 4:00131.","journal-title":"J Microbiol Exp"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1081\/DCT-120017558"},{"key":"e_1_3_5_24_1","first-page":"96","article-title":"A study of the effect of ascorbic acid on the antiplasmodial activity of artemether in Plasmodium berghei infected mice","volume":"2","author":"Ganiyu KA","year":"2012","unstructured":"Ganiyu KA, , Akinleye MO, , Fola T. A study of the effect of ascorbic acid on the antiplasmodial activity of artemether in Plasmodium berghei infected mice. J Appl Pharm Sci, 2012; 2:96\u2013100.","journal-title":"J Appl Pharm Sci"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.4049\/immunohorizons.1900076"},{"key":"e_1_3_5_26_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702004000500007"},{"key":"e_1_3_5_27_1","doi-asserted-by":"publisher","DOI":"10.1538\/expanim.59.239"},{"key":"e_1_3_5_28_1","unstructured":"Higgins JPT Green S. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Collaboration: Chichester UK; 2011."},{"key":"e_1_3_5_29_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9962860"},{"key":"e_1_3_5_30_1","doi-asserted-by":"publisher","DOI":"10.3923\/pjn.2012.62.63"},{"key":"e_1_3_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2021.101891"},{"key":"e_1_3_5_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00727-x"},{"key":"e_1_3_5_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7270.2006.00127.x"},{"key":"e_1_3_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-4165(98)00005-1"},{"key":"e_1_3_5_35_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-20-08"},{"key":"e_1_3_5_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003071"},{"key":"e_1_3_5_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmr043"},{"key":"e_1_3_5_38_1","first-page":"186","article-title":"Plasma cholesterol, B-carotene and ascorbic acid changes in human malaria","volume":"27","author":"Njoku OU","year":"1995","unstructured":"Njoku OU, , Ononogbu IC, , Nwachukwu DE. Plasma cholesterol, B-carotene and ascorbic acid changes in human malaria. J Commun Dis, 1995; 27:186\u2013190.","journal-title":"J Commun Dis"},{"key":"e_1_3_5_39_1","first-page":"061","article-title":"Antioxidant status of Nigerian children with Plasmodium falciparum malaria","author":"Nmorsi OPG","year":"2007","unstructured":"Nmorsi OPG, , Ukwandu NCD, , Egwunyenga AO. Antioxidant status of Nigerian children with Plasmodium falciparum malaria. Afr J Microbial Res, 2007; 061\u2013064.","journal-title":"Afr J Microbial Res"},{"key":"e_1_3_5_40_1","first-page":"365","article-title":"Erythrocytic antioxidant enzymes, antioxidant vitamins and plasma malondiadehyde in malaria infected patients in Owerri","volume":"6","author":"Nnodim JK","year":"2012","unstructured":"Nnodim JK, , Nwanjo HU, , Okolie NJ, et al. Erythrocytic antioxidant enzymes, antioxidant vitamins and plasma malondiadehyde in malaria infected patients in Owerri. Aust J Basic Appl Sci, 2012; 6:365\u2013368.","journal-title":"Aust J Basic Appl Sci"},{"key":"e_1_3_5_41_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8479076"},{"key":"e_1_3_5_42_1","first-page":"40","article-title":"Antioxidant status of children with Plasmodium falciparum malaria in Owerri municipal council of Imo state","volume":"8","author":"Nwosu DC","year":"2016","unstructured":"Nwosu DC, , Obeagu EI, , Ezenwuba C, et al. Antioxidant status of children with Plasmodium falciparum malaria in Owerri municipal council of Imo state. Int J Curr Res Chem Pharm Sci, 2016; 8:40\u201346.","journal-title":"Int J Curr Res Chem Pharm Sci"},{"key":"e_1_3_5_43_1","first-page":"78","article-title":"Immune response and parasite virulence in malaria parasitemic pregnant women may depend on the antioxidant vitamins levels","volume":"7","author":"Ogbodo SO","year":"2016","unstructured":"Ogbodo SO, , Okaka ANC, , Nwagha UI, et al. Immune response and parasite virulence in malaria parasitemic pregnant women may depend on the antioxidant vitamins levels. JODAGH, 2016; 7:78\u201385.","journal-title":"JODAGH"},{"key":"e_1_3_5_44_1","first-page":"11","article-title":"Implication of oxidative stress and antioxidant defence systems in symptomatic and asymptomatic Plasmodium falciparum malaria infection among children aged 1 to 15 years in the mount Cameroon area","author":"Ojongnkpot TA","year":"2023","unstructured":"Ojongnkpot TA, , Sofeu-Feugaing DD, , Jugha VT, et al. Implication of oxidative stress and antioxidant defence systems in symptomatic and asymptomatic Plasmodium falciparum malaria infection among children aged 1 to 15 years in the mount Cameroon area. J Biosci Med, 2023; 11.","journal-title":"J Biosci Med"},{"key":"e_1_3_5_45_1","first-page":"70","article-title":"Correlation of parasite density and biochemical parameters in children with malaria infection in Calabar, South-South Nigeria","author":"Okon AU","year":"2022","unstructured":"Okon AU, , Eze BI, , Emmanuel UA, et al. Correlation of parasite density and biochemical parameters in children with malaria infection in Calabar, South-South Nigeria. Gaz Egypt Paediatr Assoc, 2022; 70.","journal-title":"Gaz Egypt Paediatr Assoc"},{"key":"e_1_3_5_46_1","first-page":"56","article-title":"Evaluation of nitric oxide and antioxidant status of Plasmodium falciparum infected pregnant Nigerian women with malaria","volume":"3","author":"Onyeneke EC","year":"2018","unstructured":"Onyeneke EC, , Ofoha PC, , Anyanwu GO, et al. Evaluation of nitric oxide and antioxidant status of Plasmodium falciparum infected pregnant Nigerian women with malaria. IDOSR J Sci Res, 2018; 3:56\u201368.","journal-title":"IDOSR J Sci Res"},{"key":"e_1_3_5_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003583"},{"key":"e_1_3_5_48_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.69660"},{"key":"e_1_3_5_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10565-014-9285-2"},{"key":"e_1_3_5_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00717727"},{"key":"e_1_3_5_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02912922"},{"key":"e_1_3_5_52_1","first-page":"397","article-title":"Evaluation of serum ascorbic acid levels in acute falciparum malaria","volume":"21","author":"Raza A","year":"2010","unstructured":"Raza A, , Khan HM, , Shujatullah F, et al. Evaluation of serum ascorbic acid levels in acute falciparum malaria. Biomed Res, 2010; 21:397\u2013400.","journal-title":"Biomed Res"},{"key":"e_1_3_5_53_1","first-page":"CD004072","article-title":"Vitamin C supplementation in pregnancy","volume":"2015","author":"Rumbold A","year":"2015","unstructured":"Rumbold A, , Ota E, , Nagata C, et al. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev, 2015:2015:CD004072.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_54_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2021.639944"},{"key":"e_1_3_5_55_1","doi-asserted-by":"publisher","DOI":"10.15252\/emmm.201809903"},{"key":"e_1_3_5_56_1","first-page":"18","article-title":"Plasma ascorbic acid levels and G-6-PD activities in symptomatic, asymptomatic malaria and malaria negative subjects","volume":"3","author":"Udiong CEJ","year":"2014","unstructured":"Udiong CEJ, , Azodoh EC, , Inyang-Etoh PC, et al. Plasma ascorbic acid levels and G-6-PD activities in symptomatic, asymptomatic malaria and malaria negative subjects. Int J Biomed Lab Sci, 2014; 3:18\u201323.","journal-title":"Int J Biomed Lab Sci"},{"key":"e_1_3_5_57_1","first-page":"96","article-title":"Comparison in serum profile of peroxidants (MDA) and non enzymatic anti oxidants (vitamins E and C) among patients suffering from Plasmodium falciparum and vivax malaria","volume":"25","author":"Upadhyay DN","year":"2011","unstructured":"Upadhyay DN, , Vyas RK, , Sharma ML, et al. Comparison in serum profile of peroxidants (MDA) and non enzymatic anti oxidants (vitamins E and C) among patients suffering from Plasmodium falciparum and vivax malaria. J Postgrad Med Inst, 2011; 25:96\u2013100.","journal-title":"J Postgrad Med Inst"},{"key":"e_1_3_5_58_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.768182"},{"key":"e_1_3_5_59_1","unstructured":"Zekar L Sharman T. Plasmodium falciparum Malaria. StatPearls: Treasure Island FL; 2022."}],"container-title":["Antioxidants &amp; Redox Signaling"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/ars.2023.0306","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/ars.2023.0306","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/ars.2023.0306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:04:33Z","timestamp":1790064273000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/ars.2023.0306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,19]]},"references-count":58,"journal-issue":{"issue":"7-9","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1089\/ars.2023.0306"],"URL":"https:\/\/doi.org\/10.1089\/ars.2023.0306","relation":{},"ISSN":["1523-0864","1557-7716"],"issn-type":[{"value":"1523-0864","type":"print"},{"value":"1557-7716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,19]]}}}