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STUDY TO KNOW THE HEMATOLOGICAL CHANGES THAT OCCUR IN MALARIA

Dr. Farah Arshad Chishtee, Dr. Afia Basit, Dr. Naima Ghias

Objective: The aim of this study is to know the hematological changes that occur during the incubation period of Malaria. Study Design: A descriptive study. Place and Duration: In the Medical Department of Mayo hospital, Lahore for six months duration from June 2018 to December 2018. Methodology: All patients over 12 years of age were included in the study because of a positive smear for falciparum malaria. The following patients were not included in this study: those suffering from non-falciparum malaria; those suffering from congenital hemolytic anemia and bleeding disorders. A thorough history and a specific clinical examination were performed, including complete blood picture, peripheral smear, platelet count, reticulocyte count, urine, prothrombin time, partial thromboplastin time. Results: Of the 100 patients, 58% were male and 42% were female (1.38: 1). Anemia was present in 34 patients (female / male ratio 1.42: 1) and showed that women were predominant. The mean age of anemic patients was 21.75. Hemoglobin range (4.2-10.5 g / dl). Hemoglobin was less than 8, in 15 patients (44.11%), male / female ratio (1: 2.25) was found. Anemia was predominantly of hemolytic origin, as determined by indirect bilirubin and an increase in reticulocyte count, and this was found in 94% of total anemic patients. Anemia type was normocytic normocytic (93%) as shown by peripheral smear and blood indexes; however, 7 patients were type small cell hypochromic. Thrombocytopenia was detected in 44 cases with female / male ratio (1.44: 1), the observed range was 20.000-38.7400 / mm3. Platelets counts less than 50000 / mm were found to be significant in 15 patients with female dominance. Most of the patients had a normal leukocyte count (n = 68), but 29% of women with male to male ratio had a leukopenia count of less than 5000 / mm3 (1.9: 1). Leukocytosis was rare in 3% of patients. Prothrombin time and APTT increased in 17% of total patients, ranging from 12.1 s to 38.5 s and 23.2 to 74 s respectively. PT> 32.5 seconds and APTT> 64 seconds were observed in 4 patients. PDF was performed only in patients with elevated PT and APTT and significantly increased in 4% of men with female ratio (1: 1). Conclusion: The complete blood picture is useful for detecting the patients with severe malaria and to get much information from them, so that early and aggressive treatment is performed on time. In addition, physicians should know the possible hematological complications of falciparum malaria and be prepared to treat the patient with blood transfusion and fresh frozen plasma. Key words: complete blood count, complications, falciparum malaria.

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