Haematological Profile in Patients With Acute Falciparum Malaria: A Hospital-Based Study

TL;DR

This study examines blood changes in patients with acute falciparum malaria and finds that anemia and low platelet counts are linked to disease severity and outcomes.

Contribution

The study identifies specific hematological and coagulation changes associated with clinical severity in acute falciparum malaria.

Findings

Severe malaria cases showed significantly lower hemoglobin, hematocrit, and platelet counts compared to uncomplicated cases.

Erythroid hyperplasia with dyserythropoietic changes was common in patients with severe anemia and low parasitaemia.

Only 7.3% of patients showed an appropriate erythropoietic response after 28 days.

Abstract

Introduction

Malaria is the most common parasitic disease affecting humans. Haematological alterations in malaria are expected, and these changes play a significant role in fatal complications. The present study aims to assess the clinical and haematological profile in patients with acute falciparum malaria and the significance of various haematological and coagulation alterations with the clinical severity of malaria.

Methods

The prospective cross-sectional study included 68 acute falciparum malaria cases. Thick and thin blood film microscopy and a rapid diagnostic kit were used to diagnose malaria. The cases were subjected to various haematological and biochemical investigations. Bone marrow aspiration samples were also collected. Using appropriate statistical methods, the findings were compared between severe and uncomplicated malaria cases. A p-value below 0.05 was considered significant.

Results

The participants’ ages ranged from 14 to 78. Most participants (n = 51, 75%) were male and belonged to the lower income group (33, 48.5%). Significant variations in mean parasite count between severe and uncomplicated malaria cases (p-value < 0.01) were observed. The severe and uncomplicated groups showed significant differences in haemoglobin (gm/dL), haematocrit, red blood cell count, reticulocyte, serum iron, and ESR levels (p-value < 0.05). The severe malaria group had considerably reduced mean platelet counts (p-value < 0.01). Only five instances (7.3%) had an appropriate erythropoietic response after day 28. Erythroid hyperplasia with dyserythropoietic alterations was most common in patients with severe anaemia and low-grade parasitaemia.

Conclusion

Acute falciparum malaria is often associated with haematological alterations. Anaemia and thrombocytopenia were the most expected alterations associated with disease prognosis and mortality.

Figures