Abstract
BACKGROUND: Malaria, a prevalent disease in Sudan, has a significant impact on socioeconomic conditions. Cytokines play a crucial role in regulating the immune response during infectious diseases. This study investigates the interplay between malaria and immune response modulation in the River Nile State, focusing on tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), transforming growth factor-beta1 (TGF-β1), and interleukin-10 (IL-10). METHOD: Ninety participants with microscopy-confirmed malaria were enrolled. Parasite density and COVID-19 co-infection were assessed. Cytokine levels were measured using ELISA. RESULTS: TNF-α, IFN-γ, and TGF-β1 levels were significantly associated with parasite density (P < 0.05), but not IL-10. TGF-β1 was significantly higher in P. vivax infections, while IL-10 was elevated in P. falciparum cases. Uric acid levels were lower in participants co-infected with COVID-19 (P < 0.05). CONCLUSION: The study's findings show how cytokines affect the immune response, impacting both parasite clearance. TNF-α, IFN-γ, and TGF-β1 are positively linked to parasite density (r = 0.42, 0.38, 0.51; P < 0.01). IL-10 levels were higher in P. falciparum compared to P. vivax (560.0 vs. 415.6 pg/mL, P = 0.019).