Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis
Abstract D-dimer, a byproduct of cross-linked fibrin degradation, arises during the fibrinolysis process, breaking down blood clots in circulation. This systematic review and meta-analysis aimed to synthesize evidence of D-dimer alteration in people with malaria, including variations in disease seve...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-024-84907-x |
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| author | Suriyan Sukati Kwuntida Uthaisar Kotepui Frederick Ramirez Masangkay Ching-Ping Tseng Aongart Mahittikorn Nsoh Godwin Anabire Polrat Wilairatana Kinley Wangdi Hideyuki J Majima Apiporn Thinkhamrop Suwannatrai Wiyada Kwanhian Klangbud Wanida Mala Rujikorn Rattanatham Manas Kotepui |
| author_facet | Suriyan Sukati Kwuntida Uthaisar Kotepui Frederick Ramirez Masangkay Ching-Ping Tseng Aongart Mahittikorn Nsoh Godwin Anabire Polrat Wilairatana Kinley Wangdi Hideyuki J Majima Apiporn Thinkhamrop Suwannatrai Wiyada Kwanhian Klangbud Wanida Mala Rujikorn Rattanatham Manas Kotepui |
| author_sort | Suriyan Sukati |
| collection | DOAJ |
| description | Abstract D-dimer, a byproduct of cross-linked fibrin degradation, arises during the fibrinolysis process, breaking down blood clots in circulation. This systematic review and meta-analysis aimed to synthesize evidence of D-dimer alteration in people with malaria, including variations in disease severity. The systematic review was registered in PROSPERO with registration number CRD42024528245. Searches were performed in EMBASE, Scopus, MEDLINE, PubMed, Nursing & Allied Health Premium, and Journals@Ovid on March 25, 2024, to identify original studies that reported D-dimer in patients with Plasmodium infections. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Thematic synthesis and meta-analysis were carried out to synthesize the findings of the included studies. A total of 24 studies were included in the review out of 1,115 records identified. According to the evaluated studies, patients with Plasmodium infections had higher D-dimer levels. A meta-analytic evaluation of D-dimer levels between patients with and without Plasmodium infections revealed a significant elevation of D-dimer in patients with infection, with high heterogeneity (SMD = 2.11, 95% CI = 0.59; 3.64, P = 0.007, I² = 98%, 6 studies, 1,418 participants, random-effects model). However, no significant alterations in D-dimer levels were observed following the comparison between patients with severe and uncomplicated malaria, also with high heterogeneity (SMD = 2.54, 95% CI = -1.60; 6.68, P = 0.23, I² = 99%, 3 studies, 595 participants). The findings suggested that malaria patients have significantly higher D-dimer levels compared to non-malarial individuals. However, there was no significant difference in D-dimer levels between severe and uncomplicated malaria cases. These results highlight the potential of D-dimer as a biomarker for Plasmodium infections, but its clinical utility requires further validation. Future studies should prioritize standardizing D-dimer measurement methods, including assay types, threshold values, and sample types, to ensure consistent and reliable application in clinical settings. Additionally, large, multicentric cohorts are needed to establish robust guidelines for incorporating D-dimer into malaria management practices. Further research should also explore the role of D-dimer in the pathogenesis of Plasmodium infections to deepen our understanding of their clinical significance. |
| format | Article |
| id | doaj-art-25522dceacda404e8f0d91d6e1b107de |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-25522dceacda404e8f0d91d6e1b107de2025-01-05T12:22:56ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-024-84907-xElevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysisSuriyan Sukati0Kwuntida Uthaisar Kotepui1Frederick Ramirez Masangkay2Ching-Ping Tseng3Aongart Mahittikorn4Nsoh Godwin Anabire5Polrat Wilairatana6Kinley Wangdi7Hideyuki J Majima8Apiporn Thinkhamrop Suwannatrai9Wiyada Kwanhian Klangbud10Wanida Mala11Rujikorn Rattanatham12Manas Kotepui13Medical Technology, School of Allied Health Sciences, Walailak UniversityMedical Technology Program, Faculty of Science, Nakhon Phanom UniversityDepartment of Medical Technology, Faculty of Pharmacy, University of Santo TomasGraduate Institute of Biomedical Science, College of Medicine, Chang Gung UniversityDepartment of Protozoology, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Biochemistry & Molecular Medicine, School of Medicine, University for Development StudiesDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol UniversityHEAL Global Research Centre, Health Research Institute, Faculty of Health, University of CanberraMedical Technology, School of Allied Health Sciences, Walailak UniversityDepartment of Parasitology, Faculty of Medicine, Khon Kaen UniversityMedical Technology Program, Faculty of Science, Nakhon Phanom UniversityMedical Technology Program, Faculty of Science, Nakhon Phanom UniversityMedical Technology Program, Faculty of Science, Nakhon Phanom UniversityMedical Technology Program, Faculty of Science, Nakhon Phanom UniversityAbstract D-dimer, a byproduct of cross-linked fibrin degradation, arises during the fibrinolysis process, breaking down blood clots in circulation. This systematic review and meta-analysis aimed to synthesize evidence of D-dimer alteration in people with malaria, including variations in disease severity. The systematic review was registered in PROSPERO with registration number CRD42024528245. Searches were performed in EMBASE, Scopus, MEDLINE, PubMed, Nursing & Allied Health Premium, and Journals@Ovid on March 25, 2024, to identify original studies that reported D-dimer in patients with Plasmodium infections. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Thematic synthesis and meta-analysis were carried out to synthesize the findings of the included studies. A total of 24 studies were included in the review out of 1,115 records identified. According to the evaluated studies, patients with Plasmodium infections had higher D-dimer levels. A meta-analytic evaluation of D-dimer levels between patients with and without Plasmodium infections revealed a significant elevation of D-dimer in patients with infection, with high heterogeneity (SMD = 2.11, 95% CI = 0.59; 3.64, P = 0.007, I² = 98%, 6 studies, 1,418 participants, random-effects model). However, no significant alterations in D-dimer levels were observed following the comparison between patients with severe and uncomplicated malaria, also with high heterogeneity (SMD = 2.54, 95% CI = -1.60; 6.68, P = 0.23, I² = 99%, 3 studies, 595 participants). The findings suggested that malaria patients have significantly higher D-dimer levels compared to non-malarial individuals. However, there was no significant difference in D-dimer levels between severe and uncomplicated malaria cases. These results highlight the potential of D-dimer as a biomarker for Plasmodium infections, but its clinical utility requires further validation. Future studies should prioritize standardizing D-dimer measurement methods, including assay types, threshold values, and sample types, to ensure consistent and reliable application in clinical settings. Additionally, large, multicentric cohorts are needed to establish robust guidelines for incorporating D-dimer into malaria management practices. Further research should also explore the role of D-dimer in the pathogenesis of Plasmodium infections to deepen our understanding of their clinical significance.https://doi.org/10.1038/s41598-024-84907-xD-dimerFibrin degradation productsPlasmodiumMalariaSystematic review |
| spellingShingle | Suriyan Sukati Kwuntida Uthaisar Kotepui Frederick Ramirez Masangkay Ching-Ping Tseng Aongart Mahittikorn Nsoh Godwin Anabire Polrat Wilairatana Kinley Wangdi Hideyuki J Majima Apiporn Thinkhamrop Suwannatrai Wiyada Kwanhian Klangbud Wanida Mala Rujikorn Rattanatham Manas Kotepui Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis Scientific Reports D-dimer Fibrin degradation products Plasmodium Malaria Systematic review |
| title | Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis |
| title_full | Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis |
| title_fullStr | Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis |
| title_full_unstemmed | Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis |
| title_short | Elevations in D-dimer levels in patients with Plasmodium infections: a systematic review and meta-analysis |
| title_sort | elevations in d dimer levels in patients with plasmodium infections a systematic review and meta analysis |
| topic | D-dimer Fibrin degradation products Plasmodium Malaria Systematic review |
| url | https://doi.org/10.1038/s41598-024-84907-x |
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