MALARIA;

Assessment of haematological changes

Abstract

Objectives: To see the effects of malaria infection on platelet count and haemoglobin in children suffering from malaria.
Design: Descriptive study. Setting: CMH Okara and CMH Pano Aqil Cantt. Period: July 2008 to June 2012. Methodology: Children
admitted with fever of less than seven days duration who had positive smear for malaria parasite were included in the study. After detailed
history and thorough examination, patients were investigated to find out the cause of fever. All the patients with localizing cause for fever
and history of drug intake were excluded. All patients were investigated with complete blood counts and serial peripheral smears for
malaria parasite. Peripheral blood smear examination for malarial parasite was taken as gold standard for the diagnosis of malaria. Cut off
9 value for low hemoglobin (anemia) was taken as 10gm/dl and platelet count of less than 150x10 /L, was used to define
thrombocytopenia. Patients with thrombocytopenia were divided in to three categories. Mild thrombocytopenia was defined as patients
9 9 9 with platelet count of <50x10 /L to >150x10 /L, moderate thrombocytopenia included patients with platelet counts of <20x10 /L to
9 9 >50x10 /L and severe thrombocytopenia consisted of patients with platelet counts of <20x10 /L. Results: A total of one hundred and
fourteen smear positive patients were analyzed, out of which 93% had low and 7% had normal platelet count. 95% had Vivax and only 5%
9 9 9 had Falciparum malaria. Mean platelet count was 87x10 /L. Mean platelet count in Falciparum was 42x10 /L whereas it was 88 x10 /L in
Vivax malaria. Sixty two (54%) patients had anaemia. Mean haemoglobin was 9.54gm/dl. Mean Hb in Falciparum malaria was 7.5gm/dl
and in Vivax it was 9.6gm/dl. Conclusions: Higher frequency of mild to moderate thrombocytopenia and anaemia was observed in
hospitalized children suffering from malaria. Plasmodium Vivax was found to be the most common species.