DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20195497

A cross sectional study of thrombocytopenia in malaria positive cases in a tertiary care hospital of Bareilly

Ajay K. Agarwal, Ghanshyam D. Katiyar, Swati Khan, Bharat C. Chaudhary, Mahendra Sharma, Dharmendra Kumar

Abstract


Background: To find out correlation of thrombocytopenia with malaria. Malaria is a protozoal disease caused by infection with parasite of genus Plasmodium. Thrombocytopenia is a common and early sign of malarial infection and 60-80% thrombocytopenia is observed in malarial cases and present more frequently and severe in complicated P. falciparum malaria.

Methods: A cross sectional study done in Central Pathological Lab of Department of Pathology, RMCH, Bareilly. Blood samples collected in ethylenediaminetetraacetic acid vial and blood smear was examined for malaria parasite within red blood cells. Malaria rapid test was done for detection of Plasmodium species and platelet count was done.

Results: 780 cases of malaria was studied from September 2018 to December 2018, male predominance of 54.5%, maximum malarial positive cases 26.92% in the age group of 21-30 years, maximum 86.28% cases were of P. vivax, and thrombocytopenia was observed in 91.54% cases.

Conclusions: Mostly developing countries with limited resources and trained health manpower are malaria-endemic region of world. Thrombocytopenia is associated with both P. vivax and P. falciparum infections. In our study significance association between malaria and thrombocytopenia has been observed. We suggest malaria should be a consideration in all patients with fever and thrombocytopenia.


Keywords


Malaria, P. vivax, Thrombocytopenia

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References


White NJ, Breman JG. Harrison’s Principles of Internal Medicine. 18th edition. Volume. I US: The McGraw Hill Companies, Inc; 2012: 1688.

Sitprija V. Nephropathy in falciparum malaria. Kidney Int. 1988;34(6):867-77.

Naqvi R, Ahmad E, Akhtar F, Naqvi A, Rizvi A. Outcome in severe acute renal failure associated with malaria; Nephrol Dial Transplant. 2003;18(9):1820-3.

World Health Organization, World Malaria Report; 2015. Available at: http://www.who.int/malaria/ media/world_ malaria_report_2015. Accessed on 26 August 2019.

World Health Organization, World Malaria Report; 2011. Available at: http://www.who.int/malaria/ media/world_ malaria_report_2011. Accessed on 26 August 2019.

Yadav D, Chandra J, Dutta AK. Benign tertian malaria; how benign it is today? Indian J Pediatr. 2012;79(4):525-7.

Beale PJ, Cormack JD, Oldrey TB. Thrombocytopenia in malaria with immunoglobulin (IgM) changes. Br Med J. 1972;1(5796):345-9.

Agarwal SS, Nath A, Sharma P, Srivastava IK, Dwivedi SR, Dutta GP. Comparative evaluation of Plasmodium knowlesi and P. cynomology antigens in the indirect fluorescent antibody test for human malaria. Indian J Med Res. 1983;77:616-22.

Lacerda MVG, Mourao MPG, Coelho HCC, Santos JB. Thrombocytopenia in malaria: who cares? Mem Inst Oswaldo Cruz. 2011;106(1):52-63.

Angchaisuksiri P Coagulopathy in malaria. Thromb Res. 2014;133:5-9.

Erhart LM, Yingyuen K, Chuanak N, Buathong N, Laoboonchai A, Miller RS, et al. Hematologic and clinical indices of malaria in a semi-immune population of Western Thailand. Am J Trop Med Hyg. 2004;70:8-14.

Moulin F, Lesage F, Legros AS, Maroga C, Moussavou A, Guyon P, et al. Thrombocytopenia and Plasmodium falciparum malaria in children with different exposures. Arch Dis Child. 2003;88:540-1.

Genton B, D'Acremont V, Rare L, Baea K, Reeder JC, Alpers MP, et al. Plasmodium vivax and mixed infections are associated with severe malaria in children: a prospective cohort study from Papua New Guinea. PLoS Med. 2008;5(6):881-9.

Kochar DK, Tanwar GS, Khatri PC, Kochar SK, Sengar GS, Gupta A, et al. Clinical features of children hospitalized with malaria: a study from Bikaner, Northwest India. Am J Trop Med Hyg. 2010;83(5):981-9.

Tjitra E, Anstey NM, Sugiarto P, Warikar N, Kenangalem E, Karyana M, et al. Multidrug –resistant Pv malaria associated with high morbidity and mortility. PLoS Med. 2008;5(6):e128.

Bakhubaira S. Hematological parameters in severe complicated Plasmodium falciparum malaria among adults in Aden. Turk J Haematol. 2013;30:394-9.

Mania RN, Walsh D, Gaddy C, Hongo G, Waitumbi J, Otineo L, et al. Impact of plasmodium falciparum infection on haematological parameters in children living Western Kenya. Malar J. 2010:9(3):4.

Van Wolfswinkel ME, Vliegenthart –Jongbloed K, De Mendonca Melo M, Wever PC, McCall MB, Koelewijn R, et al. Predictive value of lympho-cytopenia and the neutrophil- lymphocyte count ratio for severe imported malaria. Malar J. 2013;12:101.

Luxemburger C, Ricci F, Nosten F, Raimond D, Bathet S, White NJ. The epidemiology of severe malaria in an area of low transmission in Thailand. Trans R Soc Trop Med Hyg. 1997;91:256-262.

WHO. World Malaria Report 2010. Geneva: World Health Organization; 2011.

Bisoffi Z, Van den EJ. Costs of treating malaria according to test results. BMJ. 2008;336:168-9.

Bisoffi Z, Gobbi F, Angheben A, Van den EJ. The role of rapid diagnostic test in managing malaria. PLoS Med. 2009;6:e1000063.

Acremont VD, Lengeleler C, Mshinda H, Mtasiwa D, Tanner M, Genton B. Time to move from presumptive malaria treatment to laboratory confirmed diagnosis and treatment in African children with fever. PLoS Med. 2009;6:252.

English M, Reyburn H, Goodman C, Snow RW. Abandoning presumptive antimalarial treatment for febrile children aged less than five years-a case of running before we can walk? PLos Med. 2009;6:e1000015.

Gerstl S, Dunkley S, Mukhtar A, De SM, Baker S, Maikere J. Assessment of two malaria rapid diagnostic test in children under five years of age, with follow up of false positive pLDH test results in a hyperendemic falciparum malaria area, SierraLeone. Malar J. 2010;9:28.

WHO. Guidelines for the treatment malaria. Geneva: World Health Organization; 2010.

Dacie SJ, Lewis SM. Reference ranges and normal values, Practical haematology. 10th edition, UK, Churchill Livingstone Publication; 2006: 14-17.

Bethesda. U.S Department of Health and Human Services; National Cancer Institute Criteria for Adverse Events. Version 3; 2006: 4

Gupta NK, Bansal SB, Jain UC, Sahare K. Study of Thrombocytopenia in Patients of Malaria. Trop Parasitol. 2013;3(1):58-61.

Jairajpuri Z, Rana S, Jaseem S, Jetley S. Thrombocytopenia and Malaria: A Coincidental Co-Existence or a significant Association? An Analysis. Ann Pathol Lab Med. 2015;2(2):48-53.

Khuraiya P, Sharma SS, Thakur AS, Pandey VP, Verma S. The Study of Clinical, Biochemical and Hematological profile in Malaria Patients. Int J Adv Med. 2016;3(2):209-17.

Gill MK, Makkar M, Bhat S, Kaur T, Jain K, Dhir G. Thrombocytopenia in Malaria and its Correlation with different types of Malaria. Ann Trop Med Public Health. 2013;6(2):197-200.

Ahmad S, Adil F, Shahzad T, Yahiya Y. Severe malaria in children: Factors predictive of outcome and response to Quinine. J Pak Med Assoc. 2011;61(1):54-8.

Aundhakar S, Prajapati P, Prajapati S, Aundhakar A, Kothia D, John D, et al. Study of Clinical and Hematological Profile of Plasmodium vivax Malaria in a Tertiary Care Hospital in Western Maharashtra. Int J Scienti Study. 2017;5(3):257-60.

Kalavathi GP, Kumar SD. Clinical, Haematological and Biochemical Profile of Malaria Cases.: Int J Med Res. 2016;1(4):50-5.

Faseela T, Roche S, Anita KB, Malli CS, Rai Y. Diagnostic value of platelet count in malaria. J Clin Diagn Res. 2011;5:464–6.

Patel A, Jain S, Patel B, Modi B. Hematological changes in P. falciparum and P. vivax malaria; Nat J Med Res. 2013;3(2):130-3.

Kashinkunti M, Alevoor S. Clinical, Haematological and Coagulation Profile in Malaria. Sch J App Med Sci. 2014;2(2):584-8.

Agravat AH, Dhruva GA. Haematological Changes in Patients of Malaria. J Cell Tissue Res. 2010;10(3):2325-9.

Akhtar S, Gumashta R, Mahore S, Maimoon S. Hematological Changes in Malaria: A Comparative Study. J Pharm Biol Sci. 2012;2(4):15-9.