Haematological Alterations in Initially Diagnosed and Relapse/Recurrent Cases of Malaria: A Comparative Study
EC06-EC09
Correspondence
Dr. Sanjay Kaushik,
Associate Professor, Department of Pathology, Shri Mahant Indresh Hospital and Shri Guru Ram Rai,
Institute of Medical and Health Sciences (Sgrrim and Hs), Patel Nagar, Dehradun-248001, Uttarakhand, India.
E-mail: skaushikjnmc@gmail.com
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.