Role of Hematological Parameters as an Indicator of Acute Malarial Infection in Uttarakhand State of India

Abstract

BackgroundMalaria may be associated with complications which may be avoided by early diagnosis and treatment. Microscopic diagnosis showing presence of malarial parasites is needed for confirmation which at times may be unreliable and requires technical expertise. The present study was conducted to statistically analyze the haematological parameters including platelet indices which can give initial hint for malarial infection and therefore prompt the laboratory physician for active search of the parasite microscopically.MethodsA retrospective study was conducted which included 334 cases of acute malaria caused by Plasmodium vivax, falciparum and dual infection along with 100 cases of control. Routine haematological parameters along with platelet indices (MPV and PDW) which are easily available on automated cell counter were statistically analyzed to assess their role as indicators for malaria.ResultsLeukocyte count and platelet count were significantly lower in cases of acute malaria in comparison to controls (p value <0.001). Platelet count<150×109/l showed 87.2% sensitivity, 65% specificity, 89.3% positive predictive value and 2.49 likelihood ratio for the infection. PDW of 6–10 and MPV>8 fl had 71.9% and 61.5% sensitivity and 78.2% and 77.7% positive predictive value respectively for infection. Platelet count <150×109/l and MPV>8 fl was comparatively more sensitive indicator for vivax (88% and 70.8% respectively) than falciparum (84.8% and 50.4% respectively) and PDW 6–10 was more sensitive indicator for falciparum (82.6%) than vivax (69.5%) infection.ConclusionThrombocytopenia (<150×109/l) and low leukocyte count (<4×109/l) may be used as probable indicator for malaria in endemic countries. Higher MPV (>8 fl) and PDW of 6–10 also show considerable sensitivity for malarial infection. In addition, thrombocytopenia (<150×109/l) and higher MPV (>8 fl) was more sensitive for vivax infection while PDW 6–10 was more sensitive for falciparum infection.

Correlation of Type of Species and Parasite Density in Malaria With Platelet Count, Mean Platelet Volume and Platelet Distribution Width

“…(1) Malaria is an important infectious protozoan disease and early diagnosis of malaria is a key feature of its prompt treatment and prevention of complications. (2) Main complications of malaria are coma, hypoglycaemia, acidosis, renal failure and pulmonary oedema. (2) Microscopic diagnosis is needed for confirmation of malaria, but it requires technical expertise and may be at times unreliable when poorly executed.…”

“…(2) Main complications of malaria are coma, hypoglycaemia, acidosis, renal failure and pulmonary oedema. (2) Microscopic diagnosis is needed for confirmation of malaria, but it requires technical expertise and may be at times unreliable when poorly executed. (3) Haematological changes which include low platelet count, haemoglobin concentration and haematocrit have been reported to be associated with malaria.…”

Thrombocytopenia and Altered Platelet indices as potential Marker in complicated malaria caused by Plasmodium vivax: cross sectional descriptive study

“…[32] Sushma et al study shows thrombocytopenia associated with increase in mean platelet volume and leucopenia were considered sensitive indicator for plasmodium vivax infection. [31] PCT was low in this study, since PCT is measure of platelet biomass (which is due to concominant thrombocytopenia associated with P.vivax).…”

Study of Biochemical Aspects in Women Infected with Trichomonas vaginalis in Babylon Province

“…(Chandra & Chandra, 2013).There are some research and biochemical studies that dealt with other parasites and their effects in some liver function, including the study conducted by the Al-Jowari & Hussein (2014) who has studied the relationship between toxoplasmosis and some biochemical indicators in the women infected with Toxoplasma gondii. Also Singh et al (2015)who has studied the relationship between the Infection of malaria parasite and the rate of AST, ALT enzymes.…”