Study of Effect of Hematological Parameters in Malaria Infection-Our Experience in a Tertiary Care Centre
Authors/Creators
- 1. Assistant Professor, Andhra Medical College, Visakhapatnam
- 2. Senior Resident, Andhra Medical College, Visakhapatnam
- 3. Associate Professor, Andhra Medical College, Visakhapatnam
- 4. Associate Professor, Government Medical College, Rajamahendravaram
Description
Background: Malaria is a significant health problem in India, being one of the biggest burdens in terms of morbidity and mortality. The mortality rate is high in severe malaria (10-30%), and hematological changes play a crucial role in morbidity and mortality. Monocytes, neutrophils, and lymphocytes play a vital role in the induction of immune responses to malaria infection and their parameters have been proven as predictors of malaria infection and its clinical severity. Materials and Methodology: This study was done for a period of 2 years i.e., from October 2017 to September2019, in the Department of Pathology, Andhra medical college, Visakhapatnam, during which 107 smear positive cases and 100 controls were studied. In suspected malaria cases Peripheral smear, Thick & Thin Smear & Rapid diagnostic test was done. Rest of the sample was subjected to SYSMEX 5-PART-Hematologyanalyzer to determine the Monocyte to Lymphocyte Count Ratio (MLCR), Monocyte to Neutrophil Count Ratio (MNCR) and Neutrophil to Lymphocyte Count Ratio (NLCR). Results: Out of 107 smear positive cases, P. vivax is the most common species causing Malaria. 35 cases had severe Malaria with more cases attributed to P. falciparum followed by P. vivax infections. Severe anaemia is seen in 33 cases (30.84%) in which P. falciparum association is predominant. Moderate thrombocytopenia is the most common presentation. Severity of anaemia and thrombocytopenia correlated with parasitemia. Among leucocyte count ratios – there is significant correlation between Monocyte to Lymphocyte Count Ratio (MLCR) and parasitemia. Conclusion: The grade of anaemia and thrombocytopenia increases with the severity of malaria especially in P. falciparum infection. MLCR (Monocyte Lymphocyte Count Ratio) can be used as a screening tool/biomarker along with clinical and other haematological parameters to predict the severity of malaria.
Abstract (English)
Background: Malaria is a significant health problem in India, being one of the biggest burdens in terms of morbidity and mortality. The mortality rate is high in severe malaria (10-30%), and hematological changes play a crucial role in morbidity and mortality. Monocytes, neutrophils, and lymphocytes play a vital role in the induction of immune responses to malaria infection and their parameters have been proven as predictors of malaria infection and its clinical severity. Materials and Methodology: This study was done for a period of 2 years i.e., from October 2017 to September2019, in the Department of Pathology, Andhra medical college, Visakhapatnam, during which 107 smear positive cases and 100 controls were studied. In suspected malaria cases Peripheral smear, Thick & Thin Smear & Rapid diagnostic test was done. Rest of the sample was subjected to SYSMEX 5-PART-Hematologyanalyzer to determine the Monocyte to Lymphocyte Count Ratio (MLCR), Monocyte to Neutrophil Count Ratio (MNCR) and Neutrophil to Lymphocyte Count Ratio (NLCR). Results: Out of 107 smear positive cases, P. vivax is the most common species causing Malaria. 35 cases had severe Malaria with more cases attributed to P. falciparum followed by P. vivax infections. Severe anaemia is seen in 33 cases (30.84%) in which P. falciparum association is predominant. Moderate thrombocytopenia is the most common presentation. Severity of anaemia and thrombocytopenia correlated with parasitemia. Among leucocyte count ratios – there is significant correlation between Monocyte to Lymphocyte Count Ratio (MLCR) and parasitemia. Conclusion: The grade of anaemia and thrombocytopenia increases with the severity of malaria especially in P. falciparum infection. MLCR (Monocyte Lymphocyte Count Ratio) can be used as a screening tool/biomarker along with clinical and other haematological parameters to predict the severity of malaria.
Files
IJPCR,Vol16,Issue1,Article119.pdf
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Additional details
Dates
- Accepted
-
2023-12-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue1,Article119.pdf
- Development Status
- Active
References
- 1. Malaria, Park. K Park's Textbook of Preventive Medicine. 21st edition Jabalpur: m/s Banarsidas Banot ; 2015; 192201. 2. Campo B, Vandal O, Wesche DL, Burrows JN. Killing the hypnozoite—drug discovery approaches to prevent relapse in Plasmodium vivax. Pathog Glob Health. 2015; 109: 107–22. 3. Sicuri E, Vieta A, Linder L, Constenla D, Sauboin C. The economic cost of malaria in children in the sub-Saharan countries, Ghana, Tanzania and Kenya. Malar J. 2013; 12:307. 4. World Malaria Report 2018, Geneva: World Health Organization 2019. 5. Narsaria N, Das BK, Mishra SP, Prasad R. Oxidative stress in children with severe malaria. J Trop Pediatr. 2012;58:147–6. 50. 7. Kotepui M, Piwkham D, PhunPhuech B, Phiwklam N, Chupeerach C, Duangmano S. Effects of malaria parasite density on blood cell parameters. PLoS ONE. 2015; 10: e0121057. 8. Wolfswinkel M, Vliegenthart Jongbloed K, Melo M, Wever P, McCall M, Koelewijn R et al. Predictive value of lymphocytopenia and the neutrophil lymphocyte count ratio for severe imported malaria. Malar J 2013; 12:101. 9. Tangteerawatana P, Krudsood S, Kanchanakhan N, Troye‑Blomberg M, Khusmith S. Low monocyte to neutrophil ratio in peripheral blood associated with disease complication in primary Plasmodium Falciparum infection. Southeast Asian J Trop Med Public Health 2014; 45:517-30. 10. Berens-Riha N, Kroidl I, Schunk M, Alberer M, Beissener M, Pritsch M, et al. Evidence for significant influence of host immunity on changes in differential blood count during malaria. Malar J. 2014; 13:155. 11. Erhart LM, Yingyuen K, Chuanak N, Buathong N, Laoboonchai A et al. Haematologic and Clinical Indices of Malaria in a SemiImmune Population of Western Thailand. Am J Trop Med Hyg.2004; 70:8-14. 12. Jadhav UM, Patkar VS, Kadam NN. Thrombocytopenia in Malaria- Correlation with Type and Severity of Malaria. J Assoc Physicians India.2004;52:615-8 13. Surve KM S et al.study of hematological parameters in malaria, Int J Res Med Sci. 2017 Jun;5(6):2552-2557) 14. S. Sumathi (S. Sumathi Correlation of hematological parameters in Malaria positive cases – A retrospective study: International Journal of Medical Microbiology and Tropical Diseases, April-June, 2016;2(2):48-51) 15. Motchan et al (Motchan PA, Subashchandrabose P, Basavegowda M, Suryanarayan A. Hematological features in malarial infection and their variations with parasite density: A retrospective analysis of 6‑year data in an Indiancity. Int J Health Allied Sci 2019; 8:53-60.) 15. Philipose CS et al (Philipose CS, Umashan kar T. The role of haematological parameters in predicting malaria with special emphasis on neutrophil lymphocyte count ratio and monocyte lymphocyte ratio: Asingle Institutional experience. Trop Parasitol [serial online] 2016 [cited 2019 Jun 3 ];6:147-150 16. Deepti Arora et al., Haematological Alterations in Initially Diagnosed and Relapse/Recurrent Cases of Malaria: A Comparative Study: Journal of Clinical and Diagnostic Research. 2018 Sep, Vol-12(9): EC06-EC09) 17. Rojanasthien S, Surakamolleart V, Boonpucknavig S, Isarangkura P. Hematological and coagulation studies in malaria. J Med Assoc Thai 1992;75 Supl 1:190-194 18. Bashawri LAM, Mandil AA, Bahnassy AA, Ahmed MA. Malaria: Haematological Aspects. Annals of Saudi Medicine 2002; 22:372-7 19. Khuraiya P et al. The study of clinical, biochemical and hematological profile in malaria patients: Int J Adv Med. 2016 May;3(2):209- 217 20. Agravat and Dhruva: hematological changes in patients of malaria; Journal of Cell and Tissue Research Vol. 10(3) 23252329 (2010). 21. Chotivanich K, Silamut K, Day NPJ. Laboratory diagnosis of malaria infection-a short review of methods. Aust J Med Sci 2006; 27: 11- 15. 22. Miller LH, Baruch DI, Marsh K. The pathogenic basis of malaria. Nature 2002; 415: 673- 679 23. Greenwood B, Marsh K, Snow R. Why do some African children develop severe malaria? Parasitol Today, 1991; 7: 277280 24. Biswas R, Sengupta G, Mundle M. A Controlled Study on Haemograms of Malaria Patients in Calcutta. Indian J Malariol.1999;36:42-8 69 25. Sharma SK, Das RK, Das BK, Das PK. Haematological and coagulation profile inacute falciparum malaria. J Assoc Physicians India 1992; 40:581-3 26. Wickramasinghe SN, Abdalla SH. Blood and bone marrow changes in malaria. Baillieres Best Pract Res Clin Haematol 2000; 13:277- 99. 27. Davis TM, Krishna S, Loopreesuwan, Supanaranond W, Pukruttayakamee S, Attatamsooonthorn & white NJ. Erythrocyte sequestration and anaemia in severe falciparum malaria. Analysis of acute changes in venous hematocrit using a simple mathematical model. J Clin Invest. 1990; 86(3):793-800. 28. Yeka A, Nankabirwa J, Mpimbaza A, Kigozi R, Arinaitwe E, Drakeley C, et al. (2015) Factors Associated with Malaria Parasitemia, Anemia and Serological Responses in a Spectrum of Epidemiological Settings in Uganda. PLoS ONE 10 (3): e0118901. doi:10.1371/ journal.pone.0118901 29. Antwi‑Baffour et al: Correlation of malaria parasitaemia with peripheral blood monocyte to lymphocyte ratio as indicator of susceptibility to severe malaria in Ghanaian children: Malar J (2018) 17:419 30. Warimwe GM, Murungi LM, Kamuyu G, Nyangweso GM, Wambua J, Naranbhai V, et al. The ratio of monocytes to lymphocytes in peripheralblood correlates with increase susceptibility to clinical malaria in KenyanChildren. PLoS ONE. 2013; 8: e57320.)31. Louis dias et al (Louis Dias, Akshay, & Sumanth, D. Usefulness of Various Peripheral BloodLeukocyte Count rations in Malaria Evaluation. International Journal of Health Sciencesand Pharmacy (IJHSP), 2017; 1(2): 52-60. 32. Senaldi G, Vesin C, Chang R, Grau GE and Piguet PF. Role of Polymorphonuclear Neutrophil Leukocytes and Their Integrin CD11a (LFA-1) in the Pathogenesis of Severe Murine Malaria. Infection and Immunity1994; 62:1144-1149. 33. Horstmann RD, Dietrich M, Bienzle U, Rasche. H Malaria induced thrombocytopenia. Blut 1981; 42:157-64 34. Srichaikul T, Pulket C. Platelet dysfunction in malaria. Southeast Asian J Trop Med Pub Health 1988; 19:225-33. 35. 35. Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton RJC. et al. Changes in white blood cells and platelets in children with falciparum malaria: relationship to disease outcome. Brit J Haematol 2002; 119:839-47