Abnormal Changes of Hematological Parameters in Malarial Infection

Manas Kotepui


Malaria is a tropical disease caused by 6 species of protozoa in genus Plasmodium, namely - Plasmodium falciparum, P. vivax, P. ovalecurtisi, P. ovalewallikeri, P. malariae, and P. knowlesi. Hematological changes are some of the most common complications found in malaria infection and play a major role in malarial pathogenesis. Previous studies indicated that 25.4% of infected patients were found associated with anemia.  Complete blood count (CBC) analysis in malarial infected patients revealed that red blood cells (RBC), white blood cells (WBC), and platelets were significantly lower than those in non-malarial infected subjects. Moreover, the percentage and number of WBC were also changed such that higher neutrophils and monocytes presented. Neutrophils and monocytes were 70% and 8% higher in patients with malarial infection respectively whereas the lymphocyte percentage was lower. The mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) parameters were also lower in patients with malaria. Eighty-five percent of patients with malaria had significantly lower platelet count (less than 1.5x105/µL). Patients with high parasitemia had higher WBC count, higher neutrophil count but lower lymphocyte and monocyte counts. Red blood cell count and hemoglobin level were also significantly lower in high parasitemia but MCV and MCH were significantly lower in patients with moderate parasitemia. Platelet count was dramatically dropped in patients with high parasitemia. Patients with P. falciparum infection had lower RBC, WBC, neutrophils, platelets, and hemoglobin level than those in patients with P. vivax infection. In contrast, patients with P. falciparum infection had higher MCV, MCH, MCHC, monocytes, and eosinophils than those in patients with P. vivax infection. Red cell distribution width (RDW) in both types of malarial infection were similar.

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