Leucocyte Count as a Marker of Severity in Malaria

Abstract

Objective: To analyze if leucocyte count could aid the diagnosis of malaria and if it could help in judging the severity and thus the prognosis. Material and Method: Out of 374 patients admitted to a tertiary hospital with history of fever, 100 subjects diagnosed with malaria were included for the study. Other causes of fever were excluded. Relevant hematological profile was done and patients were categorized to those with leucopenia (<4000cells/mm 3 ), leucocytosis (>11000cells/mm 3 ) and normal count. The results were compared by chisquare test (x 2 ). Results: Of the 69 subjects with vivax malaria, 21.7% had leucopenia while 7.2% had leucocytosis and of the 31 subjects with falciparum malaria, 16.2% had leucopenia while 6.45% had leucocytosis. Presence of leucopenia particularly in vivax malaria was significantly associated with anemia (p< 0.001) and thrombocytopenia (p<0.0027) when compared to those having leucocytosis and those with normal leucocyte count. Conclusion: Whether leucopenia can prove to be a predictor for vivax malaria needs further large scale studies. However we propose leucopenia may be considered along with anemia and thrombocytopenia in prognosticating, particularly vivax malaria.

Changes in WBC and platelet count in patients with malaria: a hospital based comparative study

“…Some study showed higher number of cases with leucopenia in compared to our study. 3,8,9 The leucocyte count in malaria is low to normal due to localization of leucocyte away from peripheral circulation to spleen rather than destruction or stasis. 10 Sometimes neutrophilia accompanied by reduced lymphocytes in patients usually leads to the suspicion of acute bacterial infection among clinicians.…”

“…Many study showed leucopenia, leucocytosis, neutrophilia, eosinophilia and monocytosis. 3,4 Thrombocytopenia is also well recognized and frequent complication of both P. falciparum and P. vivax malaria and its presence in patients with acute febrile illness increases probability of malaria. 5 In India incidence of thrombocytopenia reported in a range from 24% to 94% in various literature.…”