Anemia and Thrombocytopenia in Malaria: An Observational Study of 115 Patients in Mardan, Pakistan.

Abstract

Objective: The aim of present study was to evaluate hematological changes in malaria in
Mardan, Pakistan.
Methods: This prospective observational study was conducted at O.P.D of Mardan Medical
Complex Mardan from July to September 2015. A total of 115 patients were divided to age groups
of <15 and > 15 years old. Malaria parasite was examined using thick and thin smears
stained with Giemsa stain and also cross-checked by ICT. Those patients with a confirmed
diagnosis of malaria were investigated for platelets, hemoglobin and total leukocyte count on
Automatic hematology analyzer (Mindray) and studied by hematologist. Data was tabulated,
descriptive statistics analyzed; the chi-square test was applied to evaluate statistical significance
of the studied variable between groups on SPSS version 20. A p-value of 0.05 or less was used for
statistical significance.
Results: A total of 115 patients were included in the study. Male were 56(48.7%) and females
59(51.3%), the mean age of study group was 10.62(3.89). According to age group, patients were
divided into two groups; those <15 years comprised of 102(88.7%), while > 15 years were found
13(11.3%). P. vivax was seen in 108(93.9%) and P. falciparum 7(6.1%) patients. Out of total
population 70(60.9%) were found anemic, 79(68.7%) had mild thrombocytopenia and 4(3.5%)
with moderate thrombocytopenia and sever leucopenia were found 2(1.7%), mild leucopenia
24(20.9%), mid leucocytosis 1(0.9%). Patients with P.vivax aged <15 years had found anemia
59(62.1%) with p=0.56, moderate thrombocytopenia 4(4.2%) (p=0.05), sever leucopenia
2(2.11%), mild leucopenia 13(13.7%) and mild leukocytosis 1(1.1%) with p=0.001.
Conclusions: The present study concludes that thrombocytopenia and anemia are common
hematological findings in patient with Plasmodium infection particularly vivax species infection in
Mardan region. Therefore, malaria should be a consideration in febrile patients with low platelets
and haemoglobin.