Abstract
Malaria is a life-threatening infectious disease that, in severe cases, is associated with calamitous complications and far-reaching consequences within a community. It is usually manifested by abnormalities in various hematological indices with anemia and thrombocytopenia being the most frequent ones. The present study sheds light on the laboratory profile of patients suffering from malaria and provides a comprehensive analysis and correlation with the available literature worldwide. The study was carried out as a cross-sectional study at OK Diagnostic Lab and Research Center in Peshawar from October 2010 to October 2013. All malaria parasite (MP)-positive cases reported at OK Lab during the study period were employed in the study, making a total of 136 MP positive cases. Complete blood pictures with platelet counts were obtained in all patients and various hematological indices were analyzed according to the World Health Organization (WHO) criteria. Thrombocytopenia was defined as a platelet count of < 150 × 103/cmm and anemia as an hemoglobin (Hb) < 13 g/dL in males and < 12 g/dL in females. Among the 136 MP positive patients, 74 (55.4%) had associated thrombocytopenia while 105 (77.2%) patients showed anemia on a peripheral blood smear. This was followed by leukopenia in 8.8% of cases. Among patients with Plasmodium falciparum (P. falciparum) infection, anemia was present in 80% of cases as compared to 74% cases with P. vivax infection (p = 0.5). Thrombocytopenia was associated with P. vivax infection in 71.4% of cases in contrast to P. falciparum infection, where 26% of cases had associated thrombocytopenia (p = 0.01). On the contrary, leukopenia was more prevalent in P. falciparum patients (18%), followed by P. vivax (2.6%), and mixed parasitemia (11.1%) (p < 0.001). In addition, the study showed statistically significant variations in hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and platelet counts across different malarial species (p < 0.05). Likewise, variations within mean Hct levels among males and females were statistically significant, with females showing lower mean Hct levels than males (p < 0.05).
Highlights
Malaria is considered to be a life-threatening infectious disease that, in severe cases, is associated with calamitous complications and can inflict drastic and far-reaching consequences within a community
Hb was low in 77.2% of patients, Hct in 81.6% patients, and Mean Corpuscular Volume (MCV) was found low in 57.3% cases, again showing that majority of our patients were anemic having a microcytic hypochromic picture
Researchers have suggested thrombocytopenia as a result of consumption by disseminated intravascular coagulation (DIC) and peripheral platelet destruction induced by P. falciparum, the latter mechanism has not been systematically evaluated in P. vivax malaria [8]
Summary
Malaria is considered to be a life-threatening infectious disease that, in severe cases, is associated with calamitous complications and can inflict drastic and far-reaching consequences within a community. The existence of this disease can be traced back to 2700 years BC in China and historians have even reported Alexander to be a victim of it during the battle of Mesopotamia in the fourth century BC [1]. Four species of Plasmodium, including P. falciparum, P. vivax, P. ovale, and P. malariae, have been known to cause infections in humans. Since 2004, increasing data has been published with regards to an increase in its incidence in various Southeast Asian countries [5]
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