Serum Uric Acid as a Biomarker of Disease Severity in Children With Complicated Malaria: A Cross-Sectional Study From Eastern India

Background: Malaria continues to be a significant contributor to morbidity among children in tropical countries. Increasing evidence suggests that elevated uric acid levels may reflect inflammatory activity and disease severity in malaria. The aim of this study was to measure serum uric acid (SUA) levels in children with complicated malaria and to examine their association with clinical outcomes and biochemical markers of hepatic dysfunction. Methods: A hospital-based cross-sectional investigation was carried out in the Pediatrics Department of a tertiary care teaching hospital in eastern India from 01/09/2022 to 31/05/2024. A total of 102 children aged 1-18 years with laboratory-confirmed complicated Plasmodium falciparum malaria were enrolled using purposive sampling. Clinical details and laboratory parameters, which include SUA, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), total bilirubin, and C-reactive protein (CRP), were recorded. IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States) was used for statistical analysis. Results: Hyperuricemia was detected in 80.4% (82) of the participants. Elevated SGOT, SGPT, and bilirubin levels were observed in 72.5% (74), 83.3% (85), and 65.7% (67) of cases, respectively. Adverse outcomes occurred in 29.4% (30) of patients. Significant associations were found between adverse outcomes and abnormal SGOT (χ²=6.499, p=0.011), SGPT (χ²=8.500, p=0.004), and bilirubin (χ²=8.300, p=0.004), whereas SUA levels were not significantly associated with outcomes (p=0.115). Conclusion: Hyperuricemia is common in pediatric complicated malaria and may reflect infection-related inflammation. However, SUA alone may not reliably predict adverse clinical outcomes. Larger multicenter studies are needed.