Changes in blood counts, serum lactate dehydrogenase activity and haptoglobin level in malaria infected subjects in Nnewi, Anambra state, Nigeria

Nancy C. Ibeh, Enyioma A. Udeh, Clara I. Ajuba, Patrick O. Manafa


Background: Malaria is a mosquito-borne public health problem which alters the blood counts, haptoglobin level and serum lactate dehydrogenase (sLDH) activity of the infected individuals. Some of the alterations are associated risk factors in malaria pathology. This study aims at elucidating changes in blood counts, sLDH activity and haptoglobin level in malaria infected subjects seen in a Tertiary Health Institution in Nnewi, as search for associated risk factors in malaria pathology.

Methods: This cross sectional study enrolled 270 age matched subjects between 18-65 years. The test group (200) who tested positive to P. falciparium was placed into two groups based on their parasite counts with cut-off of  ≥1000 parasites x 109/L. Group one (100) had counts above the cut-off and group two (100) below. The control (70) was aparasitemic. The demographic data were noted and 4mls of blood drawn. 2mls in K3EDTA was for FBC testing using Mythic 22 hematology analyzer, and remaining dispensed into plain tubes was for sLDH assay by kinetic method and haptoglobin by ELISA technique.

Results: The HCT, Hb, RBC and Platelet count of test were progressively significantly lowered (p=0.001) compared to control, with an intra-significant difference among the 3 groups (p<0.05), also the parameters were found to have an inverse significant relationship (p=0.001) to the parasite counts. This trend was also seen with haptoglobin while reverse was the case with LDH activity which rather increased significantly (p = 0.000) at opposite direction as parasite density increases.

Conclusions: This study show that the degree of intravascular haemolysis is directly influenced by the parasite density, this portends that high endemicity and perennial parasiteamia in the study area could cause chronic anaemia and thrombocytopenia in the population studied.


Blood counts, Haptoglobin, Lactate dehydrogenase, Malaria parasiteamia

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