Abstract

ABSTRACT
 Malaria is a tropical infectious disease with high morbidity and mortality rates. In malaria, various kinds of haematological complications can arise, one of which is thrombocytopenia. Thrombocytopenia is most commonly encountered during acute malaria infection with varying degrees observed in both Plasmodium falciparum and Plasmodium vivax infections. The purpose of this study was to determine the relationship between the types of Plasmodium falciparum and Plasmodium vivax with the degree of thrombocytopenia in malaria patients at the Ratu Aji Putri Botung Penajam Paser Utara Hospital. This research is an observasional analytic study with cross sectional method. The data was taken by using purposive sampling method from the medical records of malaria patients hospitalized in Ratu Aji Putri Botung Penajam Paser Utara Hospital in the period of January 2013 - August 2018. Data analysis used the Chi-square test. Of the 310 malaria patients who were study subjects, 60,3% (n = 187) were infected with Plasmodium falciparum and 39,7% (n = 123) were infected with Plasmodium vivax. Most of the research subjects were male (95,8%) who were dominated by adults (56,5%). As many as 90% of malaria patients experienced thrombocytopenia with mild, moderate, and severe thrombocytopenia respectively 29,4% ; 56,6% ; 14,0%. Severe thrombocytopenia was more common in falciparum malaria patients (16,4%). The statistical test result for the type of Plasmodium with the degree of thrombocytopenia were p = 0,139. It was concluded that there was no relationship between the types of Plasmodium falciparum and Plasmodium vivax with the degree of thrombocytopenia in malaria patients.
 Keywords: Malaria, Plasmodium, Degree of Thrombocytopenia

Highlights

  • The term malaria comes from two Italian words, namely “mala” means bad and “aria” means air because at that time this disease was often found in swampy areas that emitted a foul smell into the air in Rome. 1 The disease is caused by intracellular obligate protozoa in the blood of the genus Plasmodium

  • 4 Penajam Paser Utara is the only area with high level of malaria endemicity outside the eastern region of Indonesia which is located in the Province of East Kalimantan. 5

  • The majority of malaria patients at Ratu Aji Putri Botung Penajam Paser Utara hospital were infected with Plasmodium falciparum (60,3%) followed by Plasmodium vivax infection (39,7%)

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Summary

Introduction

The term malaria comes from two Italian words, namely “mala” means bad and “aria” means air because at that time this disease was often found in swampy areas that emitted a foul smell into the air in Rome. 1 The disease is caused by intracellular obligate protozoa in the blood of the genus Plasmodium. 1 The disease is caused by intracellular obligate protozoa in the blood of the genus Plasmodium. There are 5 types of Plasmodium that can cause malaria : Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi. 7 Thrombocytopenia is the most common haematological complication of malaria, especially in Plasmodium falciparum and Plasmodium vivax infections. 9 One study stated that there was a 2.4-fold increased risk of hospitalized and a 4.7-fold increased risk of death in malaria patients with severe thrombocytopenia. 9 Several studies have linked between thrombocytopenia to the infecting Plasmodium species. Devineni et al, (2015) found that Plasmodium falciparum infection often caused a decrease in amount of platelet to a severe degree than Plasmodium vivax infection, whereas another study by Kochar et al, (2010) found the opposite. Devineni et al, (2015) found that Plasmodium falciparum infection often caused a decrease in amount of platelet to a severe degree than Plasmodium vivax infection, whereas another study by Kochar et al, (2010) found the opposite. 12.13

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