• Shuaib Ansari
  • Haji Khan Khoharo
  • Allauddin Abro
  • Israr Ahmd Akhund
  • Fatima Qureshi


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 falciparum


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) 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


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.



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