Correlation between Thrombocytopenia and Anaemia in Plasmodium falciparum malaria among patients in Kisumu County-Western Kenya

Abstract

Malaria is associated with haematological complications which may be avoided by early diagnosis and treatment. Microscopic diagnosis showing presence of malarial parasites is needed for confirmation which requires technical expertise. The study was therefore carried out to determine the diagnostic value of haemoglobin and platelet parameters in malaria patients. The study was conducted in Kisumu County-Kenya a holoendemic malaria region. Plasmodium falciparum infection status was determined using both thick and thin smears in infected; n=157 and non-infected; n=71 patients presenting with acute febrile illness at JOOTRH. Severe to moderate anaemia was present in 78 %( n=122) of malaria infected patients against 47 %( n=33) of the non-infected group (p<0.001) while thrombocytopenia was present in 87 %( n=137) of the infected patients against 10 % (n=7) of the non-infected group (p<0.001). All participants’ demographics and haematological parameters i.e. haemoglobin level, platelet count, mean platelet volume and platelet distribution width were analysed. Spearman correlation test revealed a positive correlation between anaemia and thrombocytopenia during malaria infection (ρ= 0.26, p<0.001). Non-parametric analysis showed that both haemoglobin and platelet counts were significantly lower in the malaria infected group compared to non-infected group [Hb; 7.7g/dl vs. 10.2g/dl and platelet counts; 88x109/l vs. 297x109/l respectively, (p<0.001)]. Conversely, mean platelet volume and platelet distribution width were higher in infected group relative to non-infected group [MPV; 17.77fL vs. 17.08fL and PDW; 9.81% vs. 7.98% respectively, (p<0.001). Taken together, these results show that platelet count and haemoglobin levels are important predictors of P. falciparum malaria when used in combination with other clinical manifestations and can be used in diagnosis of malaria.