Interpretation on coexistence or association of thrombocytopenia with malaria

Niraj Nepal,Nirajan Mainali,Prabesh Kumar Choudhary

doi:10.3126/jpn.v9i1.23442

Abstract

Background: Malaria is a major health problem especially in developing countries. It is a major causeof morbidity and mortality especially in the tropics. There are several hematological changes in thisparticular disease, which includes thrombocytopenia, anemia , atypical lymphocytosis and infrequentlyintravascular coagulation. The aim of the study is to detect and compare the severity of varioushematological changes, especially thrombocytopenia in the particular type of malaria.Materials and Methods: This was an observational study done on the patients attending the outpatientand inpatient departments clinically suspected for malaria in Nobel Medical College, Biratnagar, Nepal.Thick and thin slides were made and stained with Leishman’s stain for malarial parasites and also antigentests were included wherever necessary. Other tests included were, complete blood counts.Results: Amongst the included 800 patients with suspicion of malaria, 135 (17%) patients demonstratedmalarial parasites on peripheral blood film. Male predominance in male to female predominance of 3.5:1was observed. Total number of 120 out of 135 had thrombocytopenia. Thrombocytopenia was observedhigher in P. Vivax (79.3%) followed by Mixed infection (17%) and P. falciparum (3.7%) respectively.Conclusion: Anemia with mainly thrombocytopenia was mainly seen in P. Vivax type followed by P.Falciparum. Since thrombocytopenia is associated with malaria, which is demonstrated in our study,treating physicians should keep malaria as one of the differential diagnosis in patients with fever and lowplatelets.

Highlights

Malaria is a major health problem especially in developing countries, such as Asia and Africa
Inspite of advancement in technology it still continues to be a major health problem in most of the populated countries, which poses an economic burden to the concerned countries[1] It is stated that more than 40% of the world population reside in malaria-endemic area and it is predictable that 300-500 million cases and 1.5-2.7 million deaths occurs each year.[2]
Thrombocytopenia comprises of 70%, severe anemia 25% in patients suffering with malaria, blood cell count can be normal or low, leukocytosis i.e. high blood cell count comprises of less than 5% which is considered to be a bad prognostic factor.[5]

Summary

Introduction

Malaria is a major health problem especially in developing countries, such as Asia and Africa It is a major cause of morbidity and mortality especially in the tropics. When thrombocytopenia observed in peripheral blood film which lacks the normal quantity in patients presenting with fever, it is a clue indicating that the patient is suffering from malaria.[4] Since the exact mechanism of thrombocytopenia is not clear, it is assumed that immune mediated lysis, sequestration in the spleen, dyspoetic process in bone marrow with decreased platelet production play a major role in the process.[5] The aim of the study was to detect and compare the severity of various hematological changes, especially thrombocytopenia in the particular type of malaria. The aim of the study is to detect and compare the severity of various hematological changes, especially thrombocytopenia in the particular type of malaria

Objectives

Methods

Results

Discussion

Conclusion