Background: Oxidative stress and nitric oxide (NO)–mediated immune responses play critical roles in malaria pathophysiology. This study evaluated circulating NO levels and glutathione-dependent antioxidant enzymes in malaria-infected patients compared with healthy controls.

Methods: A total of 110 malaria patients (including Plasmodium vivax and Plasmodium falciparum infections) and 76 healthy controls were included in the biochemical analysis. Serum nitric oxide (NO), glutathione-S-transferase (GST), glutathione peroxidase (GPx), and glutathione reductase (GR) activities were measured using standard spectrophotometric methods. NO levels were further analyzed according to gender and stratified axillary body temperature.

Results: Serum NO levels were significantly elevated in malaria-infected patients compared with healthy controls, with slightly higher concentrations observed in P. falciparum than in P. vivax infections. Gender-based analysis showed increased NO levels in both males and females with malaria, without significant inter-gender differences. Temperature stratification revealed elevated NO levels across all febrile groups compared with controls, although the 99–100°F group showed marginally lower levels than other febrile categories. Hemoglobin levels were relatively higher in patients with high-grade fever (101–104°F), but differences were not statistically significant. In contrast to NO, antioxidant enzyme activities were significantly reduced in infected patients. GST (p < 0.004), GPx (p < 0.006), and GR (p < 0.016) activities were markedly lower in malaria patients compared with healthy individuals.

Conclusion: Malaria infection is characterized by increased nitric oxide production accompanied by significant depletion of glutathione-dependent antioxidant enzymes, indicating enhanced oxidative stress. These findings support the involvement of redox imbalance in malaria pathogenesis and suggest that NO and antioxidant enzyme profiling may serve as potential biochemical indicators of disease status.