Haematological Alterations in Initially Diagnosed and Relapse/Recurrent Cases of Malaria: A Comparative Study

• Main Authors: Deepti Arora, Sanjay Kaushik, Sheenam Azad, Anupreet Kaur, Sanjeev Kishore
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2018-09-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: anaemia; parasitic index; severity; thrombocytopenia
• Online Access: https://jcdr.net/articles/PDF/11989/35968_CE[Ra1]_F(RK)_PF1(AB_SS)_PFA(AB_SS)_PB(AB_SHU)_PN(AP).pdf

Introduction: Malaria is endemic in India with an estimated 70- 100 million cases each year. An alteration of haematological profile is one of the hallmarks in patients with malaria. A variety of haematological alterations like progressively increasing anaemia, leucocytosis or leucopenia, thrombocytopenia have been reported. Aim: To evaluate and compare the effect of initially diagnosed cases and cases of relapse/ recurrence of malaria on haematological parameters and their correlation with Parasitic Index (PI). Materials and Methods: This prospective study included 183 patients of initially diagnosed malaria cases and 64 follow-up cases of malaria. The diagnosis of malaria was confirmed on peripheral blood film and/or malaria antigen test. Complete blood counts were performed using automated Sysmex XN-1000. MP antigen test was done by Alere bioline SD malaria antigen kit. The Pearson’s Chi-square test was used for comparison of the patient’s data for association between distribution of severe anaemia in initially diagnosed cases of malaria and in cases with relapse/recurrence in relation to PI. The association of Grade III & IV thrombocytopenia in initially diagnosed cases of malaria and in cases with relapse/recurrence in relation to PI was evaluated using the paired Student’s t-test. Results: Out of 183 initially diagnosed malaria cases, 163 cases had P. vivax and 20 cases had P. falciparum. All the cases of P. vivax and 75% of cases of P. falciparum had anaemia. All the cases had thrombocytopenia. Among 64 follow-up cases, 57 had P. vivax and 7 cases had P. falciparum infection. Approximately 50% cases of P. vivax and 40% cases of P. falciparum had normal Hb levels. Normal platelet counts were observed in 14% of P. vivax and 28.5% of P. falciparum cases. Majority of the cases (≅ 85%) of both the groups had PI ≤10. Conclusion: Anaemia and thrombocytopenia are frequent findings in malaria with severity of thrombocytopenia related to PI. Thrombocytopenia is a constant finding in initially diagnosed cases of malaria but in cases of relapse/recurrence platelet counts may be normal.