ANEMIA AND THROMBOCYTOPENIA IN MALARIA: AN OBSERVATIONAL STUDY OF 115 PATIENTS IN MARDAN, KPK, PAKISTAN

Background and Objectives: Malaria is associated with high mortality and morbidity. Pakistan is amo-ng the countries having a high infectivity rate of malaria. Active malarial transmission takes place thro-ughout the year, while aggressive out bursts of disease are seen mainly during and after the „monsoon‟ season. The aim of present study was to evaluate the hematological changes in malaria in Mardan, KPK. This was observational, cross sectional study. The study was conducted in at outpatient depart-ment of BKMC/MMC hospital Mardan from July to September 2015. Methods: A total of 115 patients were divided to age groups of 15 and 15 years old. Approval of the study was taken from Hospital Ethical Committee and informed written consent was taken from each patient prior to include in the study. All patients with fever with “no focal signs on history and clinical examination” were included in the study. Blood smear slide for MP were advised for those patients with fever with no focal signs. All patients with fever but negative for blood smear slide for MP were excluded from the study. Both thick and thin films were prepared examined. Those patients with a confirmed dia-gnosis of malaria were investigated for platelets, hemoglobin and total leukocyte count on automatic hematology analyzer (Mindray) and studied by hematologist. SPSS 20 was used for statistical analysis. Results: Out of total 115 patients; males were 56 (48.7%) and females 59 (51.3%) and mean age of study group was 10.62 ±3.89. According to age group; patients 15 years comprised of 102 (88.7%), while 15 years were found 13 (11.3%). P. vivax was seen in 108 (93.9%) and P. falciparum 7 (6.1%) patients. Out of total population 70 (60.9%) were found anemic, 79 (68.7%) had mild thrombocytopenia and 4 (3.5%) with moderate thrombocytopenia and sever leucopenia were found 2 (1.7%), mild leucopenia 24 (20.9%), mild leucocytosis 1 (0.9%). Patients with P. vivax aged 15 years had anemia 59 (62.1%) with p = 0.56, moderate thrombocytopenia 4 (4.2%) (p = 0.05), sever leucopenia 2 (2.11%), mild leuco-penia 13 (13.7%) and mild leukocytosis 1 (1.1%) with p = 0.001.Conclusion: The present study concludes that thrombocytopenia and anemia are common hematolo-gical findings in patient with Plasmodium infection particularly vivax species infection in Mardan region. Therefore, malaria should be a consideration in febrile patients with low platelets and haemo-globin.