Hematological Indices and Abnormalities Among Patients With Uncomplicated Falciparum Malaria in Kosti City of the White Nile State, Sudan: a Comparative Study

Abstract

Background: Hematological abnormalities are common features in falciparum malaria but vary among different populations across countries. Therefore, we compared hematological indices and abnormalities between Plasmodium falciparum-infected patients and malaria-negative subjects in Kosti city of the White Nile State, Sudan. Methods: A comparative, cross-sectional study was conducted at the Medical Technology Laboratory Unit of Kosti Teaching Hospital from June to December 2018. A total of 392 participants (192 P. falciparum-infected patients and 200 malaria-negative subjects) were recruited in the study. Hematological indices of hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets were measured and their median values were statistically compared.Results: The majority of P. falciparum-infected patients (64.6%) showed a low-level parasitemia. The median values of Hb concentration, RBC count, mean corpuscular Hb and mean corpuscular Hb concentration were significantly lower in P. falciparum-infected patients, with anemia being significantly higher among infected patients than malaria-negative subjects (60.4% vs. 29.5%, respectively). The median total WBC count was non-significantly higher in P. falciparum-infected patients, with leucopenia being non-significantly different between both groups. The median platelet count was significantly lower in P. falciparum-infected patients, with thrombocytopenia being significantly higher among infected patients than malaria-negative subjects (72.4% vs. 5.0%, respectively).Conclusions: Most falciparum malaria infections among patients in Kosti city of the White Nile State – Sudan are of low-level parasitemia. Nevertheless, falciparum malaria is significantly associated with anemia and thrombocytopenia with lower median values of Hb, RBC count, MCH, MCHC and platelet count in P. falciparum-infected patients than malaria-negative subjects. In contrast, leucopenia is not useful to predict falciparum malaria. Further large-scale studies in community and healthcare settings and inclusion of patients with complicated or severe malaria and those with high parasite densities are recommended.