DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161817

A study of thrombocytopenia in malaria and its prognostic significance

Mohd Arif, Shivcharan Jelia, S. R. Meena, Shivraj Meena, Pankaj Jain, Devendra Ajmera, Vinod S. Jatav, Vinit Agarwal

Abstract


Background:Malaria is one of the most common infectious diseases of tropics, affecting 300-500 million people and causing over 1 million deaths each year in the world. Malaria is a multisystem infection and can be associated with many complications. Thrombocytopenia is the most common hematological complication of malaria, but association of thrombocytopenia with different types of malaria and its prognostic implications in context with severity of low platelet count has not been evaluated in many of previous studies. Objectives of the study was to study the incidence, correlation of severity and prognostic significance of thrombocytopenia in malaria.

Methods: A total of 100 cases were included in the study and identified positive for malaria parasites on peripheral smear examination with conventional microscopy and /or by rapid diagnostic test.

Results: Present study includes 100 patient with malaria from which 78% were males and 22% were females. Most of the patients were suffering from P. vivax malaria (65%), and rest suffered from P. falciparum malaria (32%) and mixed infection (03%). Incidence of thrombocytopenia was 79%, of which mild, moderate and severe thrombocytopenia was 35.44%, 41.77% and 22.78% respectively. Complicated and uncomplicated malaria cases were 22.79% and 77.21% respectively.

Conclusion: Clinical bleeding in severe malaria is not a common feature and occurred in 5.5% of individuals with severe disease. Unnecessary platelet transfusion is not required for mild to moderate degree of thrombocytopenia in malaria patients which further avoids an unnecessary cost burden in the poor group of patients.

 


Keywords


Malaria, P. falciparum, P. vivax, Thrombocytopenia

Full Text:

PDF

References


World Health Organization. World Malaria report 2015. Available at: www.who.int/malaria/media/world_malaria_report_2015/. Accessed on 15th February 2016.

World Health Organization. World Malaria report 2011. Available at: www.who.int/malaria/world_malaria_report_2011/. Accessed on 15th October 2012.

Malaria in India. Available at http://www.malariasite.com/malariaindia/1/9. Accessed on 23rd January 2016.

Oh MD, Shin H, Shin D, Kim U, Lee S, Kim N, Choi MH et al. Clinical features of vivax malaria. Am J Trop Med Hyg. 2001;65:143-6.

Mohapatra MK, Padhiary KN, Mishra DP, Sethy G. Atypical manifestations of Plasmodium vivax malaria. Indian J Malariol. 2002;39:18-25.

Erhart LM, Yingyuen K, Chuanak N, Buathong N, Laoboonchai A 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.

Kumar A, Shashirekha. Thrombocytopenia: indicator of acute vivax malaria. Indian J Pathol Microbiol. 2006;49:505-8.

Sheikh QH, Ahmad SM, Abbasi A, Malik SA. Thrombocytopenia in malaria. J Coll Physicians Surg Pak. 2009;19:708-10.

Mahmood A, Yasir M. Thrombocytopenia: a predictor of malaria among febrile patient sof Liberia. Infectious Diseases Journal. 2008;14:41-4.

Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in Malaria correlation with type and severity in malaria. J Assoc Physicians India. 2004;52:615-8.

Patel U, Gandi G, Friedman S, Niranjan S. Thrombo cytopeniain Malaria. Journal of the National Medical Association 2004;969(9):1212-4.

Wilson J, Neame PB, Kelton JG. Infection induced thrombocytopenia. Semin Thromb Hemostasis. 1982;8:217-33.

Hill GJ, Knight V, Jerrery GM. Thrombocytopenia in vivax malaria. Lancet. 1964;1:240-1.

Looareesuwan S,Davis JG, Allen DL, Lee SH, Bunnag D, White NJ. Thrombocytopenia in malaria. South East Asian J Trop Med Public Health. 1992;23:44-50.

Memon AR, Afsar S. Thrombocytopenia in hospitalized malaria patients. Pak J Med Sci. 2006;22:141-43.

Kochar DK, Das A, Kochar A, Middha S. Thrombocytopenia in plasmodium falciparum, plasmodium vivax and mixed infection malaria: a study from Bikaner. Platelets. 2010;21(8):623-7.

Estacio RH, Edwin ER, Cresswell S, Coronel RF, Alora AT. The quantitative buffy coat technique (QBC) in early diagnosis of malaria: the santo tomas university hospital experience. Phil J Microbiol Infect Dis. 1993;22(2):56-9.

VijayaKumar G, BalaSubrahmanyam D, HemanthKumar K. Incidence and prognostic significance of thrombocytopenia in malaria. J of Evidence Based Med and Health Care. 2015;2(10):1431-35.

Dash SC, Bhuryan VN, Gupta A, Sharma LC, Kumar A, Agrawal SK. Falciparum malaria complicating cholestatic jaundice and acute renal failure. JAPI. 1994;42(2):101-3.

Madhu M, Prakash PS. A study of clinical profile of malaria in a tertiary referral centre in South Canara. J Vect Borne Dis. 2006;43:29-33.

Sudheer Babu Devineni, Obulapuram Suneetha, Nannam Harshavardhan. Study of platelet count in malaria patients and the correlation between the presence and severity of platelet count with type of malaria. Journal of Evolution of Medical and Dental Sciences. 2015;4(67):11734-46.

Dhungat MP, Dhungat P. Thrombocytopenia in Patients of Malaria: correlation with type of Malaria and its clinical significance. Online I I R Journal, (Bi-Monthly) ISSN2249-9598.

Rao BS, Vani MS, Latha GJSL. Incidence, severity, prognostic significance of thrombocytopenia in malaria. Int J Res Med Sci. 2015;3:116-21.

Shaikh MA, Ahmed S, Diju IU, Yakta DE. Platelet count in malaria patient. J Ayub Med Coll Abbottabad. 2011;23(1).

Solanki R, Thakral R, Shipra AV, Agarwal A. Thrombocytopenia in Malaria. JARBS. 2012;4(1):65-7.

Patel DKN, Pradeep P, Surti MM, Agarwal SB. Clinical manifestations of complicated malaria an overview. Journal Indian academy of clinical medicine. 2003;4(4):323-31.

Erel O, Kocyigit A, Bulut V, Avci S, Aktepe N. Role of lipids, lipoproteins and lipid peroxidation in thrombocytopenia in patients with vivax malaria. Haematologia. 1998;29:207-12.

Wattana Leowattana. Changes in platelet count in uncomplicated and severe falciparum malaria. (NCGM), Tokyo, Japan. 2010;41.