Association of advanced age with liver function and inflammatory response in patients with malaria in Luanda, Angola

Malaria remains a leading cause of mortality in sub-Saharan Africa, yet its clinical profile in older adults is poorly characterised. We therefore conducted a cross-sectional study of 518 hospitalised malaria patients aged ≤50 and >50 years in Luanda, Angola, between January 2023 and December 2024, comparing liver function, inflammatory markers, and leucocyte parameters. Older adults represented 9.8% of patients. Parasitaemia, sex, residence, and HbS genotype did not differ by age group. Older adults however showed distinct liver biomarker profiles, lower C-reactive protein positivity, lower inflammatory scores, and higher lymphocyte counts despite similar parasite density. Moderate and high inflammatory scores were inversely associated with advanced age, whereas lymphocyte count was positively associated, thus supporting the need for age-adapted clinical assessment, monitoring, and management strategies to improve outcomes in malaria.