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ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 1  |  Page : 53-60

Hematological features in malarial infection and their variations with parasite density: A retrospective analysis of 6-year data in an Indian city


1 Department of Pathology, MMetropolis Healthcare Limited –Chennai Laboratory (formerly Lister Metropolis Laboratory), Chennai, Tamil Nadu, India
2 Department of Community Medicine, JSS Medical College, Mysore, Karnataka, India

Correspondence Address:
Dr. Prabu Anandhan Motchan
Metropolis Healthcare Limited –Chennai Laboratory (formerly Lister Metropolis Laboratory), #3, Jagannathan Road, Nungambakkam, Chennai - 600 034, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_57_18

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BACKGROUND: Considering that physicians routinely perform complete blood counts (CBCs) for patients with fever in India, it is useful in comparing these counts across malaria positive and negative cases, as well as the variation of these features with parasite density. OBJECTIVES: This study aims to compare hematological characteristics in malarial positive and negative patients, compare parasite density with hematological characteristics, estimate sensitivity and specificity of hematological characteristics as indicators of malarial infection, and compare platelet distribution width (PDW) and plateletcrit (PCT) in positive cases with negative cases. MATERIALS AND METHODS: We performed a retrospective analysis of 6-year data in a pathology laboratory to compare CBC of malaria-positive (n = 299) versus malaria-negative blood (n = 287) samples. PDW and PCT tests were available for some samples (n = 100) for a subanalysis. Parasite density, determined by scoring (1+ to 4+) in quantitative buffy coat-malarial parasite detected cases (n = 279), was compared with hematological features. RESULTS: The hematology of malarial infection was characterized by bicytopenia or pancytopenia (P < 0.001, odds ratio [OR] = 11.14) of which thrombocytopenia was the most prominent component (P < 0.001, OR = 37.94), followed by anemia due to reduction in red blood cell (RBC) count effecting a decrease in packed cell volume (PCV) (P < 0.003, OR = 2.13) with an elevated red cell distribution width (P < 0.025, OR = 1.78). Higher parasite density was associated with increased incidence of anemia and severe thrombocytopenia. PDW was elevated (P < 0.001, OR = 6.93) and PCT was reduced (P < 0.001, OR = 123.64) in positive cases. CONCLUSIONS: Thrombocytopenia with reduction in PCV or reduced RBC count is a distinguishing feature of malaria.


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