Thrombocytopenia in Malaria: A hospital based study
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 10
Abstract
Malaria is an infectious vector borne parasitic disease of the genus plasmodium and transmitted by the bite of infected Anopheles mosquitoes. There are four recognized and distinct species are: Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, Plasmodium malaria [1]. However, a fifth species, Plasmodium knowlesi, has been identified as a cause of human malaria in almost all countries in Southeast Asia [2] and extending to the Nicobar and Andaman Islands in India [3]. According to the latest estimates from world health organization, there were 214 million new cases of malaria worldwide in 2015 (range 149–303 million). The African Region accounted for most global cases of malaria (88%), followed by the South-East Asia Region (10%) and the Eastern Mediterranean Region (2%). Among South East Asia region, India shares two-thirds of the burden (70%) followed by Myanmar (16%) and Indonesia (10%). In 2015, there were an estimated 438 000 malaria deaths (range 236 000–635 000) worldwide. Most of these deaths occurred in the African Region (90%), followed by the South-East Asia Region (7%) and the Eastern Mediterranean Region (2%). Between 2000 and 2015, malaria incidence rates (new malaria cases) fell by 37% globally, and by 42% in Africa. During this same period, malaria mortality rates fell by 60% globally and by 66% in the African Region.[4] A typical attack of malaria comprises three distinct stages: cold stage, hot stage and sweating stage. The clinical features of malaria vary from mild to severe, and complicated, according to the species of parasite present, the patient’s state of immunity, the intensity of infection and also the presence of concomitant conditions such as malnutrition and other disease [5]. Severity of the disease depends on the interaction of a number of factors. These include the size of the infective dose of sporozoites, nutritional status of the host, level of acquired immunity, host genetic factors, parasite growth rate, drug resistance status, socio-economic condition, availability of health care and education [6]. Malaria parasite affects multiple organs of the body such as liver, spleen, brain, gastro intestinal tract, gall bladder, pancreas, blood vessels and placenta. Hence the clinical picture could be of wide spectrum ranging from simple malaise to life threatening central nervous symptoms like coma [7-8]. Hematological abnormalities have been observed in patients with malaria, with anemia and thrombocytopenia being the most common [8-9]. Both non-immunological as well as immunological destruction of platelets have been implicated in causing thrombocytopenia but the mechanisms involved are still not completely clear. Immune-mediated lysis, sequestration in the spleen and a dyspoietic process in the marrow with diminished platelet production have all been postulated in the cause for thrombocytopenia. Abnormalities in platelet structure and function have been described as a consequence of malaria, and in rare instances platelets can be invaded by malaria parasites.[10,11,12] We conducted this study to find out the frequency and the degree of thrombocytopenia in patients with malaria.
Authors and Affiliations
Praveen Kumar
Keywords
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