Thrombocytopenia in patients diagnosed with Malaria in District Buner, KP
Introduction: Thrombocytopenia is one of the numerous complications of malaria infection, which could be lethal if not diagnosed and managed on time. Our study aims to determine the occurrence of thrombocytopenia in patients hospitalized with malaria.
Material and Methods: A retrospective cross-sectional study was conducted between January 2016 till December 2019. Data was collected from the patient’s record registers. A total of 201 cases were included in this study. Data was collected, entered, and analyzed in IBM SPSS 23 software package.
Results: Out of the total 201 cases, 108 (53.7%) were males and 93 (46.3%) were females. 189 (94%) cases were suffering from P. vivax, 10 (5%) were suffering from P. falciparum, and cases suffering from both were only 2 (1%). Thrombocytopenia was present in 183 (91.04%) cases (95% confidence interval 2.13-2.37). 91.53% (n=173) of cases diagnosed with P. vivax had thrombocytopenia while 90% (n=9) cases diagnosed with P. falciparum had thrombocytopenia.
Conclusion: We conclude from this study that, thrombocytopenia occurs in all species of malaria and is not a distinguishing feature between the principal types of malaria. With prompt identification and management, platelets count reverts back to normal.
2. Organization WH. 2018 Health SDG Profile: Nepal. 2018. https://apps.who.int/iris/handle/10665/276841
3. World Health Organization. Global technical strategy for malaria 2016-2030. World Health Organization; 2015 Nov 4.
4. Howes RE, Battle KE, Mendis KN, Smith DL, Cibulskis RE, Baird JK, Hay SI. Global epidemiology of Plasmodium vivax. The American journal of tropical medicine and hygiene. 2016 Dec 28;95(6_Suppl):15-34. DOI: https://doi.org/10.4269/ajtmh.16-0141
5. Snow RW, Guerra CA, Noor AM, Myint HY, Hay SI. The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature. 2005 Mar;434(7030):214-7.
6. Control DoM. Malaria Annual Report 2016. Directorate of Malaria control, Ministry of National Health Services RaC; 2016. http://dmc.gov.pk/documents/pdfs/Malaria%20Annual%20Report%202016.pdf
7. Mujahid CA, Arif M. Malaria situation in Pakistan to brief on National control programme. Pak J Med Res. 1998;37(4):537-9.
8. Khattak AA, Venkatesan M, Nadeem MF, Satti HS, Yaqoob A, Strauss K, Khatoon L, Malik SA, Plowe CV. Prevalence and distribution of human Plasmodium infection in Pakistan. Malaria journal. 2013 Dec;12(1):1-8.
9. Kakar Q, Khan MA, Bile KM. Malaria control in Pakistan: new tools at hand but challenging epidemiological realities. EMHJ-Eastern Mediterranean Health Journal, 16 (Supp.), 54-60, 2010. 2010.
10. Oh MD, Shin H, Shin D, Kim U, Lee S, Kim N, Choi MH, Chai JY, Choe K. Clinical features of vivax malaria. The American journal of tropical medicine and hygiene. 2001 Aug 1;65(2):143-6. DOI: https://doi.org/10.4269/ajtmh.2001.65.143
11. Khan SJ, Abbass Y, Marwat MA. Thrombocytopenia as an indicator of malaria in adult population. Malaria research and treatment. 2012;2012.
12. Lacerda MV, Mourão MP, Coelho HC, Santos JB. Thrombocytopenia in malaria: who cares?. Memorias do Instituto Oswaldo Cruz. 2011 Aug;106:52-63. https://doi.org/10.1590/S0074-02762011000900007.
13. Kho S, Barber BE, Johar E, Andries B, Poespoprodjo JR, Kenangalem E, Piera KA, Ehmann A, Price RN, William T, Woodberry T. Platelets kill circulating parasites of all major Plasmodium species in human malaria. Blood. 2018 Sep 20;132(12):1332-44. https://doi.org/10.1182/blood-2018-05-849307
14. Lampah DA, Yeo TW, Malloy M, Kenangalem E, Douglas NM, Ronaldo D, Sugiarto P, Simpson JA, Poespoprodjo JR, Anstey NM, Price RN. Severe malarial thrombocytopenia: a risk factor for mortality in Papua, Indonesia. The Journal of infectious diseases. 2015 Feb 15;211(4):623-34. https://doi.org/10.1093/infdis/jiu487
15. Gérardin P, Rogier C, Amadou SK, Jouvencel P, Brousse V, Imbert P. Prognostic value of thrombocytopenia in African children with falciparum malaria. The American journal of tropical medicine and hygiene. 2002 Jun 1;66(6):686-91. DOI: https://doi.org/10.4269/ajtmh.2002.66.686
16. Leal-Santos FA, Silva SB, Crepaldi NP, Nery AF, Martin TO, Alves-Junior ER, Fontes CJ. Altered platelet indices as potential markers of severe and complicated malaria caused by Plasmodium vivax: a cross-sectional descriptive study. Malaria journal. 2013 Dec 1;12(1):462.
17. Williamson DR, Albert M, Heels-Ansdell D, Arnold DM, Lauzier F, Zarychanski R, et al. Thrombocytopenia in critically ill patients receiving thromboprophylaxis: frequency, risk factors, and outcomes. Chest. 2013;144(4):1207-15. DOI: https://doi.org/10.1378/chest.13-0121
18. Soomro FR, Pathan GM, Gurbakhshani AL, Kakar JK. Prevalence of malarial parasites in Larkano district, Sindh, Pakistan. Gomal Journal of Medical Sciences. 2010;8(2).
19. Ibrahim SK, Khan S, Akhtar N. Epidemiological finding of malaria in district Buner Khyber Pakhtunkhwa, Pakistan. World J Med Sci. 2014;11:478-82. DOI: 10.5829/idosi.wjms.2014.11.4.9153
20. Khan I, Shah A, Awan Z. Epidemiology of Malaria in Urban and Rural Areas of Bannu District Khyber Pakhtunkhwa, Pakistan. International Journal of Modern Biology and Medicine. 2013;4(1):30-9.
21. Jamal A, Memon I, Lateef F. The association of Plasmodium vivax malaria with thrombocytopenia in febrile children. Pak Paed J. 2007;31(2):85-9. DOI: https://doi.org/10.4269/ajtmh.2004.70.8
22. Erhart LM, Yingyuen K, Chuanak N, Buathong N, Laoboonchai A, Miller RS, et al. Hematologic and clinical indices of malaria in a semi-immune population of western Thailand. The American journal of tropical medicine and hygiene. 2004;70(1):8-14.
23. Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in malaria--correlation with type and severity of malaria. J Assoc Physicians India. 2004;52:615-8.
24. Robinson P, Jenney AW, Tachado M, Yung A, Manitta J, Taylor K, et al. Imported malaria treated in Melbourne, Australia: epidemiology and clinical features in 246 patients. Journal of travel medicine. 2001; 8(2):76-81. DOI: https://doi.org/10.2310/7060.2001.24309
25. Kochar DK, Das A, Kochar A, Middha S, Acharya J, Tanwar GS, et al. Thrombocytopenia in Plasmodium falciparum, Plasmodium vivax and mixed infection malaria: a study from Bikaner (Northwestern India). Platelets. 2010;21(8):623-7. DOI: https://doi.org/10.3109/09537104.2010.505308
26. Horstmann RD, Dietrich M, Bienzle U, Rasche H. Malaria-induced thrombocytopenia. Blut. 1981 Mar 1;42(3):157-64.
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