Correlation of Presence and Severity of Thrombocytopenia with Types and Severity of Malaria

Abstract

Background: Malaria is a major public health problem in India. Malaria is commonly associated with thrombocytopenia, but its significance is not well established. A prospective study was conducted to correlate the presence and severity of thrombocytopenia with types and severity of malaria. Material and Methods: This prospective observational study was performed in the Department of General Medicine at a tertiary care center of north India from January 2019 to June 2020. A total of 100 adult patients found positive for malaria parasites on peripheral smear examination were enrolled for the analysis. Results: The incidence of thrombocytopenia was seen in 80% of total malaria patients. There was a significant ( P = 0.0001) association of severity of thrombocytopenia with symptoms and signs of malaria except for rigor. There was no significant ( P > 0.05) association of severity of thrombocytopenia with age. There was a significant ( P = 0.003) association of severity of thrombocytopenia with M antigen. The analysis of variance showed that there was a significant ( P = 0.0001) difference in Lung Function Test (LFT) and Kidney Function Test (KFT) parameters with severity of thrombocytopenia; whereas in blood parameters, only red blood cell counts were associated significantly with the severity of thrombocytopenia. Conclusion: Thrombocytopenia is a frequent overall manifestation of both falciparum and vivax malaria. Severe thrombocytopenia is identified in all age groups, commonly in males, and increases the risk of death from falciparum or vivax malaria, particularly in those with concurrent severe anemia. Early diagnosis and prompt treatment of malaria reduces the complications and adverse outcomes of the disease.

Hematological parameters in cases of malaria: A study at tertiary care hospital in Gujarat

“…In present study, the most common species of malaria was P. vivax (n=75, 76%) followed by P. falciparum (n=25, 24%). This was in concordance with studies conducted by Kumar Manoj et al [3] and Devineni S B, et al [4] . In present study, not a single case of mixed infection was noted which is in concordance with the study conducted by Surve KM et al [5] .…”

“…Male predominance was noted in present study (n=56, 56%). This was in concordance with studies conducted by Kumar Manoj et al [3] , Murthy GL, et al [6] , Trampuz A, et al [7] and Patel U, et al [8] . This may be because of frequent exposure of males to the risk of acquiring malaria than females as they mostly spend their time outdoors.…”

“…This increases the risk of exposure to malarial infection. The mean age of studied patients was 30.27±11.46 years like in study conducted by Kumar Manoj et al [3] having mean age of 33.09±13.53 years. This implies that young adults were most commonly affected which may be explained by the fact of them being active outside of home.…”

“…Malaria causes many alterations in hematological parameters, of which anemia and thrombocytopenia are the most significant. Thrombocytopenia is also seen in patients with acute febrile illness due to viral causes, but its presence is considered as a diagnostic clue for malaria in endemic areas [3] . In present study, the most common species of malaria was P. vivax (n=75, 76%) followed by P. falciparum (n=25, 24%).…”

“…A clinical gamut of fever, splenomegaly, and pallor is most often associated with malaria. Clinical signs of pallor and splenomegaly were common in studies conducted by Kumar Manoj et al [3] , Farogh A et al [9] and Piplani S et al [10] . Engwerda CR et al [11] observed that splenomegaly in malaria is due to phagocytosis of parasitised red blood cells as an immune response against parasites.…”