Thrombocytopenia in vivax and falciparum malaria: an observational study of 131 patients in Karnataka, India

Saravu, Kavitha; Docherla, M; Vasudev, Ashuma; Shastry, BA

doi:10.1179/2047773211y.0000000013

Cited by 42 publications

(43 citation statements)

References 17 publications

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“…Thrombocytopenia was present in 97.7% of malaria positive cases in our study, which was similar to the findings by Abro et al and Chandra et al 17,18 As the number of malaria cases presenting with isolated thrombocytopenia is very high, these cases should be specifically screened for malaria infestation 19…”

Section: Discussionsupporting

confidence: 91%

Automated Hematology Analyzers in Diagnosis of Plasmodium Vivax Malaria: An Adjunct to Conventional Microscopy.

Hasaf

Devadass

Aarathi

et al. 2014

Mediterr J Hematol Infect Dis

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Malaria is one of the most pervasive parasitic diseases ever known to mankind affecting nearly 300 million people every year. The need for rapid diagnosis of malaria in tropical and subtropical malaria endemic areas is on the rise. In this study, we evaluated the usefulness of hematology autoanalyzers, Sysmex XE-2100 & XT-2000i in the presumptive diagnosis of malaria. Our study shows that abnormalities in WBC/BASO scattergram when combined with presence of thrombocytopenia had a high sensitivity and positive predictive value in the presumptive diagnosis of Plasmodium vivax (P.vivax) malaria.

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Section: Discussionsupporting

confidence: 91%

Automated Hematology Analyzers in Diagnosis of Plasmodium Vivax Malaria: An Adjunct to Conventional Microscopy.

Hasaf

Devadass

Aarathi

et al. 2014

Mediterr J Hematol Infect Dis

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“…Studies have reported the significance of thrombocytopenia in relation to different species of Plasmodium and concluded that association of thrombocytopenia was statistically more significant with PV monoinfection as compared to PF and mean platelet count increased over time. 18,19 Saravu et al in their study from Karnataka, southern state of India have concluded that thrombocytopenia is observed in malaria and incidence is similar in vivax and falciparum infection and the patients with complications had significantly lower platelet count in comparison to patients without complications 20. In contrast, studies have also observed that thrombocytopenia less than 20×10 9 /L is statistically more common with falciparum infection 21.…”

Section: Discussionmentioning

confidence: 95%

Role of Hematological Parameters as an Indicator of Acute Malarial Infection in Uttarakhand State of India

Chandra

2013

Mediterr J Hematol Infect Dis

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BackgroundMalaria may be associated with complications which may be avoided by early diagnosis and treatment. Microscopic diagnosis showing presence of malarial parasites is needed for confirmation which at times may be unreliable and requires technical expertise. The present study was conducted to statistically analyze the haematological parameters including platelet indices which can give initial hint for malarial infection and therefore prompt the laboratory physician for active search of the parasite microscopically.MethodsA retrospective study was conducted which included 334 cases of acute malaria caused by Plasmodium vivax, falciparum and dual infection along with 100 cases of control. Routine haematological parameters along with platelet indices (MPV and PDW) which are easily available on automated cell counter were statistically analyzed to assess their role as indicators for malaria.ResultsLeukocyte count and platelet count were significantly lower in cases of acute malaria in comparison to controls (p value <0.001). Platelet count<150×109/l showed 87.2% sensitivity, 65% specificity, 89.3% positive predictive value and 2.49 likelihood ratio for the infection. PDW of 6–10 and MPV>8 fl had 71.9% and 61.5% sensitivity and 78.2% and 77.7% positive predictive value respectively for infection. Platelet count <150×109/l and MPV>8 fl was comparatively more sensitive indicator for vivax (88% and 70.8% respectively) than falciparum (84.8% and 50.4% respectively) and PDW 6–10 was more sensitive indicator for falciparum (82.6%) than vivax (69.5%) infection.ConclusionThrombocytopenia (<150×109/l) and low leukocyte count (<4×109/l) may be used as probable indicator for malaria in endemic countries. Higher MPV (>8 fl) and PDW of 6–10 also show considerable sensitivity for malarial infection. In addition, thrombocytopenia (<150×109/l) and higher MPV (>8 fl) was more sensitive for vivax infection while PDW 6–10 was more sensitive for falciparum infection.

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“…In this study, specifically total leucocyte count and platelet counts were lower and significantly much lower in patients with warning signs and symptoms of complications as compared to the studies done by Kochar et al from northwestern India, Taylor et al northern-east papua and Saravu et al from Karnataka. [21,22,23] Anemia has been documented in our study population and nutritional status may also be the attributive cause for it. However associated hemoglobinopathies were not excluded.…”

Section: Discussionmentioning

confidence: 62%

Thrombocytopenia and Altered Platelet indices as potential Marker in complicated malaria caused by Plasmodium vivax: cross sectional descriptive study

Bhavani

Venkatraman

A.N³

et al. 2017

APALM

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Background: Malaria is a major health problem with increased morbidity and mortality. Plasmodium falciparum and Plasmodium vivax are endemic infections in India and constitutes about 77% of the total malaria cases in Southeast Asia, commonly associated with hematological abnormalities. Hematological abnormalities that are observed in patients with malaria includes anemia and thrombocytopenia. Thrombocytopenia frequently complicates malarial infections and is usually noted in Plasmodium falciparum. In the present study we have tried to evaluate prognostic implications of altered platelet indices and factors associated with outcome of severe and complicated P. vivax malaria.Methods: This is cross sectional descriptive study of 60 patients with malaria caused by P. vivax who presented to Mahatma Gandhi medical college and research institute between june 2014 to April 2016.The smears positive for malaria exclusively caused by P.vivax infection were included in this study. Malaria was diagnosed by microscopic examination with both leishmain stained thin and giemsa stained thick smears. All blood cell counts were determined using automated equipment (ABX Pentra ES 60; Horiba) which provides MPV, PDW and PCT. Result:Out of 60 patients in the present study 56.7% were males and 43.3% were females, age of the patient ranges from 17-48 years with mean (SD) age of distribution were 32.10 (9.52).Complete blood count evaluation of all patients showed mean hemoglobin level of 9 g/dL. Mean hematocrit level of 26.68% (4.2%) and mean leukocyte count of 5866 (1170) cells/mm3. The mean platelet count was 95,247cells/ mm3. The MPV was 9.6 (0.96) µm, Mean PDW was 13.75% (0.89%) and mean PCT was 0.180% (0.033%) Conclusion: Our study concludes that history of fever associated with chills and rigor are sensitive indicator of malaria but lacks specificity. Platelet indices were altered during severe symptomatic malarial infection such as elevation of MPV and PDW with decreased PCT are the known potential risk factors associated with warning signs of acute malaria caused by plasmodium vivax. Even though these hematological parameters are useful predictors of acute malarial infection, identification of parasites and grading of parasitemia in peripheral smear were always gold standard for early treatment.

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Thrombocytopenia in vivax and falciparum malaria: an observational study of 131 patients in Karnataka, India

Cited by 42 publications

References 17 publications

Automated Hematology Analyzers in Diagnosis of Plasmodium Vivax Malaria: An Adjunct to Conventional Microscopy.

Automated Hematology Analyzers in Diagnosis of Plasmodium Vivax Malaria: An Adjunct to Conventional Microscopy.

Role of Hematological Parameters as an Indicator of Acute Malarial Infection in Uttarakhand State of India

Thrombocytopenia and Altered Platelet indices as potential Marker in complicated malaria caused by Plasmodium vivax: cross sectional descriptive study

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