Background Asymptomatic malaria is a threat to malaria eradication program. Host-related factors (e.g., immunity, oxidative stress, anti-oxidants activities) associated with asymptomatic malaria remain a gray area in research. This study seeks to determine the serum level of oxidative stress and anti-oxidants in 130 symptomatic and asymptomatic patients with different intensities of malaria parasite infection from a hospital in Ibadan, Nigeria. Results The prevalence of infection was 48.5%

more »

... the respondents. Most of the patients with parasitemia were asymptomatic (64.7%). The mean titer value of malondialdehyde (MDA) was significantly higher (p < 0.05) among those with malaria infection (6.05 ± 0.60) compared with those who tested negative for malaria parasites (2.38 ± 0.28). Furthermore, the mean titer value of MDA was significantly higher (p < 0.05) among patients who showed symptoms of malaria (5.49 ± 0.77) compared with those without symptoms (2.93 ± 0.47). A strong positive relationship existed between MDA (r = 0.717, p < 0.05), glutathione peroxidase (GPx) (r = 0.695, p < 0.05), and density of infection. On the other hand, a weak negative correlation existed between intensity and superoxide dismutase (SOD) (r = − 0.115, p > 0.05) and glutathione (GSH) (r = − 0.278, p > 0.05). The level of SOD and GSH also decreased significantly (p < 0.05) with an increase in MDA level. Conclusions This study showed that lipid peroxidation did not only increase in positive patients, it also rises in patients with clinical symptoms of malaria. Furthermore, a similar level of anti-oxidant responses was observed in both symptomatic and asymptomatic malaria patients. There is a need to inform health policies that encourage routine diagnosis and treatment of malaria in apparently healthy people if the malaria elimination goal is to be achieved in Africa.