Hematological profile in smear positive malaria cases: A cross sectional study

Abstract

Background: Malaria is a global parasitic infection, being one of the leading cause of morbidity as well as mortality. Changes in the hematological profile are considered a hallmark of malaria, as these values increase the clinical suspicion. It also helps in initiating specific therapy even in the absence of a positive smear report. Objectives: (a) To detect the most common species of malaria in the region (b) Determine the various hematological changes seen in patients with malaria. (c) Compare the hematological changes among different species of plasmodium and (d) to find out the hematological changes that can  help  in diagnosis of malaria. Methodology: A total of 100 adult patients with a positive smear for malaria were included in this study. It was an institution based cross-sectional study. Malaria was diagnosed by microscopic examination of thick and thin smear. Hematological values were determined from the blood sample of the patient by using an automated hematology analyzer.Results: In this study of 100 patients, anemia was seen in 97 % of patients, thrombocytopenia in 95%, leucopenia in 42% and monocytosis in 19% cases. Mean RBC count, mean Hb level as well as hematocrit values were significantly lower among patients with P.falciparum infection compared to P.vivax cases. Leucopenia was more common with P. falciparum infection (P value of 0.009).Conclusion and Recommendation: Anemia and thrombocytopenia were the two most common hematological changes seen in malaria cases, followed by leucopenia and monocytosis. Patients with fever, having these hematological abnormalities should alert the clinician about the possibility of malaria and these cases should be managed for their hematological abnormalities in addition to the treatment for malaria.