{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:09Z","timestamp":1787071209287,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Malaria remains a significant public health challenge in rural Iraq, particularly among children who are vulnerable due to poor nutrition and limited healthcare access. The aim of the study was to investigate the relationship between malaria and inflammatory biomarker levels in children, with a focus on the impact of nutritional deficiencies, anemia, and hematological disorders on disease progression and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>This case\u2013control study (August 2023\u2013February 2025) included 150 children with malaria and 50 controls aged 5\u20138 years in rural Iraq. Ethical approval and parental consent were obtained. Blood samples were collected in gel and EDTA tubes, processed, and stored at \u221280\u00b0C. C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor-alpha (TNF-\u03b1) were measured through the enzyme-linked immunosorbent assay, while hemoglobin was measured via complete blood count. Linear device, while iron, zinc, vitamin D, and ferritin were analyzed using the Cobas e411.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The study showed significant differences in inflammatory markers between the malaria and control groups. CRP (18.4 vs. 5.2 mg\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), IL-6 (10.2 vs. 3.1 pg\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and TNF-\u03b1 (12.5 vs. 4.0 pg\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were elevated in malaria patients. Hemoglobin (9.8 vs. 12.5 g\/dL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and iron levels (45.3 vs. 90.2 \u03bcg\/dL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were lower, while ferritin levels were higher (30.0 vs. 100.0 ng\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Malnutrition was more prevalent in the malaria group (65% vs. 15%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), as were anemia (70% vs. 20%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and blood disorders (40% vs. 10%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Zinc and vitamin D levels were also significantly reduced in malaria patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study reveals that malaria profoundly affects inflammation, nutrition, and blood health, with elevated CRP, IL-6, and TNF-\u03b1 levels, common anemia, and disrupted iron metabolism. Zinc and vitamin D deficiencies were frequent. About 65% had severe malnutrition, 70% anemia, and 40% other blood disorders. Findings stress integrated nutritional and anti-inflammatory care and call for further biomarker research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/tp.tp_26_25","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:00:18Z","timestamp":1761418818000},"page":"110-117","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of the relationship between malaria and inflammatory biomarker levels in children in rural Iraq: Impact of nutritional deficiencies, anemia, and hematological disorders"],"prefix":"10.4103","volume":"15","author":[{"given":"Aseel Kariem","family":"Al-Sultany","sequence":"first","affiliation":[{"name":"Department of Biology, University of Kerbala College of Sciences, Kerbala, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa Z.","family":"Al-Mamoori","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Kerbala College of Sciences, Kerbala, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muayad N.","family":"Kareem","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Kerbala College of Sciences, Kerbala, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama A.","family":"Mohsein","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Techniques, Mazaya University College, Thi-Qar, Iraq"},{"name":"Thi-Qar Health Directorate, Al Habbobi Teaching Hospital, Thi-Qar, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13071-022-05635-7","article-title":"Plasmodium malariae contributes to high levels of malaria transmission in a forest-savannah transition area in Cameroon","volume":"16","author":"Nguiffo-Nguete","year":"2023","journal-title":"Parasit Vectors"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/1295381","article-title":"Old and recent advances in life cycle, pathogenesis, diagnosis, prevention, and treatment of malaria including perspectives in Ethiopia","volume":"2020","author":"Nureye","year":"2020","journal-title":"Sci World J"},{"issue":"Suppl 2","key":"R5-20260420","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1159\/000371618","article-title":"The epidemiology of global micronutrient deficiencies","volume":"66","author":"Bailey","year":"2015","journal-title":"Ann Nutr Metab"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"663","DOI":"10.4269\/ajtmh.2000.62.663","article-title":"The influence of zinc supplementation on morbidity due to Plasmodium falciparum: A randomized trial in preschool children in Papua New Guinea","volume":"62","author":"Shankar","year":"2000","journal-title":"Am J Trop Med Hyg"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1002\/ajhb.20839","article-title":"Evaluation of iron deficiency as a nutritional adaptation to infectious disease: An evolutionary medicine perspective","volume":"21","author":"Wander","year":"2009","journal-title":"Am J Hum Biol"},{"key":"R8-20260420","first-page":"1235","article-title":"Morphology, biology and life-cycle of plasmodium parasites","volume":"191","author":"Hommel","year":"2007","journal-title":"Bull Acad Natl Med"},{"key":"R9-20260420","first-page":"a025577","article-title":"Immune responses in malaria. 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