THROMBOCYTOPENIA IN PLASMODIUM FALCIPARUM MALARIA
Abstract
Background: Malaria is usually associated with reduced blood cell counts & mild to moderatethrombocytopenia is a common association of malaria. The cause of thrombocytopenia is poorlyunderstood, but the immune-mediated lysis, sequestration in the spleen and dyspoietic processes inthe marrow with diminished platelet production have all been postulated. This study wasconducted to evaluate thrombocytopenia in the patients suffering from acute Plasmodiumfalciparum malaria. Methods: This descriptive case series study was conducted at a tertiary carehospital, Liaquat University of Medical & Health Sciences Jamshoro, over a one-year period. Atotal of 370 Plasmodium falciparum positive on peripheral blood film were studied. Full bloodcounts were determined by using automated Coulter analyzer. Thick & thin smears were stainedwith Giemsa stains and studied by haematologist. Data was analyzed using the SPSS version 10.0.Results: Out of 370 patients, 260 were male & 110 were female, with M:F ratio of 2.36:1. Meanage was 34±1.7 years (range 16-53 years). Haemoglobin values were 12.7±1.4g% and white bloodcells counts were found 12600±450/µL. Out of 370, 114 (30.81%) had normal platelet counts, and256 (69.18%) had thrombocytopenia (p<0.05). The mild, moderate and severe thrombocytopeniawere found in 39 (10.5%), 180 (48.6%) and 37 (10%) respectively (p<0.05). Conclusions: Wefound high frequency of mild to moderate thrombocytopenia in the Plasmodium falciparummalaria. Finding of thrombocytopenia is of diagnostic help as it raises the suspicion of malaria.Keywords: Thrombocytopenia, Malaria, Plasmodium falciparumReferences
Khan MA, Smego RA Jr, Razi ST, Beg MA. Emerging drug
resistance and guidelines for treatment of malaria. Med
Today 2006;4:81–7.
Roll Back Malaria. WHO Eastern Mediterranean Region.
Cairo, Egypt. 2002. p.1–14.
Hozhabri S, Akhtar S, Rahbar MH, Luby SP. Prevalence of
plasmodium positivity among the children treated for
malaria, Jhangara, Sindh. J Pak Med Assoc 2000;5:401–5.
Yasinzai MI, Kakarsulemankhel JK. Incidence of human
malaria infection in Barkhan and Kohlu, bordering areas of
East Balochistan. Pak J Med Sci 2008;24:306–10.
Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CR.
Changes in white blood cells and platelets in children with
falciparum malaria: Relationship to disease outcome. Br J
Haematol 2002;119:839–47.
Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in
malaria-correlation with type and severity of malaria. J
Assoc Physicians India 2004;52:615–8.
Tacchini-Cottier F, Vesin C, Redard M, Buurman W, Piguet
PF. Role of TNFR1 and TNFR2 in TNF-induced platelet
consumption in mice. J Immunol 1998;160:6182–6.
Kreil A, Wenisch C, Brittenham G. Thrombocytopenia in P
falciparum malaria. Br J Hematol 2000;109:534–6.
Kathryn NS, Kevin C, Jay SK. Malaria. CMAJ 2004;170:1503–18.
Patel U, Gandhi G, Friedman S, Niranjan S. Thrombocytopenia
in malaria. J Natl Med Assoc 2004;96:1212–4.
J Ayub Med Coll Abbottabad 2009;21(2)
http://www.ayubmed.edu.pk/JAMC/PAST/21-2/Ansari.pdf 147
Robinson P, Jenney AW, Tachado M, Yung A, Manitta J,
Taylor K et al. Imported malaria treated in Melbourn,
Austrlia: Epidemiology and clinical features in 246 patients. J
Travel Med 2001;8:76–81.
Rodriguez-Morales AJ, Sanchez E, Vargas M, Piccolo C, Colina
R, Arria M. Anemia and Thrombocytopenia in children with
Plasmodium vivax malaria. J Trop Pediatr. 2005;10:1093.
Imbert P. Criteria of severity in childhood falciparum
malaria. Arch Pediatr. 2003;(Suppl 5):532s–8s.
Bashwari LA, Mandil AM, Bahnassy AA, Alshamsi MA,
Bukhari HA. Epidemiological profile of malaria in a
university hospital in the eastern region of Saudi Arabia.
Saudi Med J 2001;22:133–8.
Lathia TB, Joshi R. Can hematological parameters
discriminate malaria from nonmalarious acute febrile illness
in the tropics? Indian J Med Sci 2004;58:239–44.
Mahmood A, Yasir M. Thrombocytopenia: A predictor of
Malaria among febrile patients in Liberia. Infect Dis J
;14:41–4.
Memon AR, Afsar S. Thrombocytopenia in hospitalized
malaria patients. Pak J Med Sci 2006;22:141–3.
Akhtar MN, Jamil S, Amjad SI, Butt AR, Farooq M.
Association of malaria with thrombocytopenia. Ann King
Edward Med Coll 2005;11:536–7.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
