tnf-α 238 alleles polymorphism and its association with tnf-α levels in the severe malaria anemia among sudanese children

Introduction: tumor necrosis factor alpha (tnf-α) levels overproduction and promoter polymorphisms at tnf-α 238 alleles may play central role in reduced red cell production and malaria-related anemia through suppression of bone marrow erythropoiesis and dyserythropoiesis. this study aimed to evaluate the tnf-α 238 allele’s polymorphism and its association with tnf-α levels in the children with falciparum malaria. methods: a longitudinal hospital-based study was conducted among 100 children with severe falciparum malaria (mean age 8.63±3.40 years) and 100 children with uncomplicated falciparum malaria (mean age 8.83±4.20 years). tnf-α level was measured using human tnf-α elisa max™ deluxe sets. pcr was used for detecting tnf-α 238 allele’s polymorphism. obtained data were analyzed by spss (version 20.0) and statdisk (version 13.0). results: tnf-α 238a allele was a common allele (66.8%). falciparum malaria-related anemia accounted for 32%, commonly in severe malaria (sm) (55%) compared to uncomplicated malaria (um) (9%) (p=0.000). otherwise, the average of tnf-α levels strongly positively correlated with the severity of anemia (r+0.309; p=0.000). the tnf-α 238 a allele accounts for 83.6% of malaria anemia (p=0.000) and 100% severe anemia (p=0.000). conclusion: overproduction of tnf-α is essential for the elimination and clearance of falciparum parasite but may be associated with severity of malaria and malaria anemia. overproduction of tnf-α in children with tnf-α 238 a allele may result in falciparum malaria-related anemia among children. these findings will assist clinicians in better managing severe malaria-related anemia cases.