<![CDATA[Malaria continues to be a major global health issue, associated with high rates of morbidity and mortality. The primary treatment is artemisinin-based combination therapy (ACT), however ts effectiveness is being threatened by resistance associated with mutations in the kelch13 (K13) gene. Furthermore, an excessive inflammatory response also plays a role in malaria pathogenesis, making immunomodulation-based therapeutic approaches an important strategy. This study aims to evaluate the potential and mecahnism of Curcuma xanthorrhiza (Javanese turmeric or temulawak) as an antiplasmodial agent and adjuvant therapy. This narrative review aimed to evaluate the potential of Curcuma xanthorrhiza as an adjuvant therapy for malaria. Literature was collected from PubMed, ScienceDirect, and Google Scholar for studies published between 2010 and 2025 using keywords related to malaria, Curcuma xanthorrhiza, artemisinin resistance, oxidative stress, and immunomodulation. A total of 268 records were identified through the database search. After duplicate removal and eligibility screening, 39 articles met the inclusion criteria and were included in this narrative review. Selected studies included experimental research, reviews, and preclinical investigations relevant to the pharmacological activity of Curcuma xanthorrhiza in malaria management. Evidence indicates that bioactive compounds such as xanthorrhizol, curcuminoids, and terpenoids exhibit moderate antiplasmodial activity and significantly regulate inflammatory pathways through inhibition of nuclear factor-kappa B (NF-κB), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and pro-inflammatory cytokines including TNF-α and IL-6. In addition, antioxidant activity contributes to reducing oxidative tissue damage associated with malaria pathogenesis. Although its direct antiparasitic potency remains inferior to artemisinin-based combination therapy (ACT), Curcuma xanthorrhiza demonstrates promising potential as a host-directed adjunctive therapy capable of enhancing immune homeostasis and mitigating malaria-associated complications. However, current evidence is predominantly limited to in vitro and animal studies.]]>
