Alteration of coagulation profile in malaria patients and its correlation with degree of parasitemia: a prospective study

Authors

  • Jayashankar CA Department of General Medicine, Vydehi Institute of Medical Sciences and Research Centre, 82, EPIP Area, Nallurhalli, Whitefield, Bangalore, Karnataka
  • Venkata BharatKumar Pinnelli Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, 82, EPIP Area, Nallurhalli, Whitefield, Bangalore, Karnataka
  • Ramya Prabhu Prabhu Clinic, Marathahalli, Bangalore, Karnataka

DOI:

https://doi.org/10.18203/2349-3933.ijam20161097

Keywords:

Malaria, Plasmodium falciparum, Prothrombin Time, Parasitemia, Thrombocytopenia

Abstract

Background: Malaria is a major health problem in many parts of India. Several factors have been attributed to increased morbidity and mortality in malaria with altered haematological and coagulation parameters playing an important role. This study was performed to find the correlation between the alteration of coagulation profile and degree of parasitemia.

Methods: Fifty patients with Malaria confirmed by PS, or Antigen assay underwent detailed clinical history, thorough physical examination and investigated with routine investigations, haematological and coagulation parameters were recruited in the study.

Results: Parasitemia was found out for each of the patients and were categorized into mild moderate and severe parasitemia. This was followed by monitoring the alteration of coagulation profile with respect to severity of parasitemia. 17 patients had increased prothrombin time and most of these patients were Plasmodium falciparum positive. Thrombocytopenia was observed in 58% of the patients. Increased PT has positive co-efficient of correlation to degree of parasitemia with an ‘r’ value of 0.65 which is significant.

Conclusions: It was found that the number of patients with increased prothrombin time increased with increase in degree of parasitemia, that is, the number of patients with deranged PT in severe parasitemia was significantly more than those in moderate parasitemia and this in turn was more than those in mild parasitemia.

References

Breman JG, Alilio MS, Mills A. Conquering the intolerable burden of malaria: what's new, what's needed: a summary. Am J Trop Med Hyg. 2004;71(2):1-15.

Hay SI, Guerra CA, Tatem AJ, Noor AM, Snow RW. The global distribution and population at risk of malaria: past, present, and future. Lancet Infect Dis. 2004;4(6):327-36.

Guerra CA, Gikandi PW, Tatem AJ, Noor AM, Smith DL, Hay SI, Snow RW. The limits and intensity of plasmodium falciparum transmission: implications for malaria control and elimination worldwide. PLoS Med. 2008;5(2):e38.

Nadkar MY, Huchche AM, Singh R, Pazare AR. Clinical Profile of Severe Plasmodium vivax malaria in a tertiary care centre in mumbai from June 2010- January 2011. JAPI. 2012;60:11.

World Malaria Report 2008. Geneva: World Health Organization 2008.

Mohapatra MK. Current status of drug-resistance malaria in India. Medicine Update. API, Eds. Agarwal AK. 2009;1:9-20.

Francischetti IMB, Seydel KB, Robson Q. Monteiro, Blood Coagulation, Inflammation and Malaria. Microcirculation. 2008;15(2):81-107.

World Health Organisation. Severe falciparum malaria. Trans R Soc Trop Med Hyg. 2000;94:S1-S90.

Rock EP, Marsh K, Saul SJ, WellemsTE, TatlorDW, MaloyWL, et al. Comparitive analysis of Plasmodium falciparum histidine rich proteins HRP1, HRP2, HRP3 in malaria diagnosis of diverse origin. Parasitology. 1987;95:209-27.

Clemons C, Pnamoolsinsap C, Lorinz R, pokrittayakanee S, Bock HL, White NJ. Activation of coagulation cascade in severe falciparum malaria through theintrinsic pathway. Br J Hemotol. 1994;87(1):100-5.

Jaroonvesama N. Intravascular coagulation in falciparum malaria. Lancet. 1977;1(7744):221-3.

GG MP. Human Cerebral Malaria: a quantitative ultrastructural analysisof parasitised erythrocyte Sequestration. Am J. Pathol. 1985;119(3):385-401.

Sharma SK, Das RK, Das BK, Das PK, Hematological and coagulation profile inAl. falciparum malaria. J Assoc Physicians India. 1992;40(9):581-3.

Butler T, Jony BJ, Fitcher HR, Robbin T. Blood coagulation studies in P2 falciparum malaria. Am Journal of Med sciences. 1973;65(1):63-7.

Melhotra B. Haematological manifestation of Malaria. Indian J Hematol Blood Transfus. 1997;15-40.

Malhotra OP, Bhatia SJC, Saxena RA. A study of clinical and hematological manifestations of malaria. Indian J Hematol Blood Transfus. 1997;15:400.

Rajanasthein. Hematological and coagulation studies in Malaria. Journal of Medical association of Thailand. 1992;75(17):190-4.

Reddy DS. A study of falciparum malaria in emergency medicine department. Indian J Hematol Blood Transfus. 1995;135(1):38.

Mehta SR. Falciparum Malaria-210 cases. JADI. 2001;2:119-20.

Horstmann RD. Malaria Induced thrombocytopenia. BLUT. 1981;421(3);157.

Kueh YK, Yeo KL. Hematological alterations in acute malaria. SJH. 1982;29(2):147.

Roy S. Hematological profile in Patients with acute falciparum malaria. JAPI. Poster Presentation. 2002; 114.

Downloads

Published

2017-01-02

Issue

Section

Original Research Articles