Hematological Profile and Gametocyte Carriage in Malaria Patients from Southern Pakistan

Abstract

Background Malarial infection is a major cause of concern, both worldwide and in Pakistan. Gametocytes are the sexual forms of the parasite that are essential for transmission. They fuse inside the mosquito to develop sporozoites. Gametocytes of the plasmodium parasites, which cause the infection, differentiate into male and female gametocytes. These gametocytes constitute the sexual stage of the malaria parasite and are essential in transmission of the disease from human to vector Anopheles. Gametocytes are affected by factors such as host immunity, drug treatment, reticulocytemia, anemia, low levels of asexual parasitemia and stress to the parasite. The aim of this study was to observe the hematological parameters, age and gametocyte carriage in an area of seasonal malaria transmission. Methods The study was conducted at Aga Khan University Hospital (AKUH) Laboratory over the period of one year and 294 patients with uncomplicated malaria were recruited. Patients infected with Plasmodium falciparum (P. falciparum) or Plasmodium vivax (P. vivax) malaria and no co-morbidities were included in the study. Results Gametocytemia was highest during the period of July to November, with P. vivax, 267 (90.8%), predominating compared to P. falciparum, 27 (9.2%). P. vivax gametocytes were observed from May to October and P. falciparum gametocytes were observed from July to December. Low hemoglobin in females and low platelet levels were observed. The mean platelet count was significantly lower in cases of P. vivax having gametocytes compared to P. falciparum with gametocytes. Higher parasitic index was associated with lower platelet count. The most significantly altered parameters were hemoglobin, hematocrit, white blood cell (WBC), and platelet count. Hemoglobin and platelets were significantly lower during the malaria season in study participants, both male and female. Conclusion In conclusion, infection with P. falciparum and P. vivax modulates significant changes in hematological parameters in populations living in malaria endemic regions. In the malaria season males were more frequently affected by malaria with thrombocytopenia. Gametocyte carriage remains unaffected by seasonal changes thus ensuring parasite transmission during the dry season.

The RELATIONSHIP BETWEEN TYPES OF PLASMODIUM FALCIPARUM AND PLASMODIUM VIVAX WITH THE DEGREE OF THROMBOCYTOPENIA IN MALARIA PATIENTS AT RSUD RATU AJI PUTRI BOTUNG PENAJAM PASER UTARA

“…This result is similar to research by Devineni et al, (2015) percentage of male malaria patients is greater, namely 75.6% compared to female malaria patients, which is only 24.4%. 12 Similar results were also reported by Ghanchi et al, (2019) where 70.4% of malaria patients were male and 29.6% of female malaria patients. 18 Men are more at risk of getting malaria because it is associated with high activities outside the home such as working.…”

“…12 Similar results were also reported by Ghanchi et al, (2019) where 70.4% of malaria patients were male and 29.6% of female malaria patients. 18 Men are more at risk of getting malaria because it is associated with high activities outside the home such as working. 16 The dominance of the types of work in the forestry, agriculture and fisheries sectors in the Penajam Paser Utara region also explains why malaria cases in male patients are so high in this region.…”

Hematological indices and abnormalities among patients with uncomplicated falciparum malaria in Kosti city of the White Nile state, Sudan: a comparative study

“…Overall, the findings of the present study should be interpreted cautiously because hematological indices and abnormalities in malaria may differ, among other factors, with the level of disease endemicity, disease severity, nutritional and immune status of patients, iron deficiency, co-existence of hemoglobinopathies as well as demographic factors [ 6 , 13 , 25 , 35 , 42 – 48 ]. Furthermore, this study is limited by the fact that it was hospital-based, and the hematological findings might not reflect the situation at the population level, particularly among asymptomatic carriers.…”

Genetic Characterization of Plasmodium vivax Isolates from Pakistan Using Circumsporozoite Protein (PvCSP) and Merozoite Surface Protein-1 (PvMSP-1) genes as genetic markers 

“…Malaria remains a serious infectious disease of public health importance and one of the leading causes of morbidity and mortality worldwide [1]. Globally, around 42% population is at risk with almost 228 million cases of malaria with 0.4 million reported deaths in 2018 based on the data collected from 91 countries [2,3].…”