Clinico-Hematological Profile of Malaria Diagnosed by Peripheral Blood Smear in a Tertiary Care Hospital

Background: Despite its low incidence in developed nations, malaria continues to be a major cause of acute febrile illness in tropical areas, and is often associated with hematological abnormalities, which can increase the severity of the illness. Laboratory diagnosis is still based primarily on the peripheral blood smear examination. The objective is to compare the clinical and hematological profile of malaria diagnosed from peripheral blood smear and to determine whether there are any correlations between the hematological abnormalities and Plasmodium species. Material and Methods: A total of 150 patients with blood smear confirmed malaria were subjected to this prospective observational study that was performed in a tertiary care hospital. The clinical characteristics, malaria species and hematological indices such as red cell indices, hemoglobin, total leukocyte count, hematocrit and platelet count were studied. Data were analysed statistically using SPSS version 25.0. Results: The majority were aged between 21 and 40 years and males constituted 62.7% of the study population. P. vivax was detected in 64.0% of the cases, P. falciparum was detected in 30.7% of cases and mixed infection was detected in 5.3% of cases. All the patients had fever, chills and rigors. The most frequent hematological abnormality was thrombocytopenia (69.3%) followed by anemia (54.7%). The frequencies of anemia, thrombocytopenia, and severe thrombocytopenia were significantly higher in patients with P. falciparum infection compared to those with P. vivax infection (p<0.05). Abnormalities of leukocytes occurred in a relatively small number of cases. Conclusion: Examination of peripheral blood smear is still a good diagnostic tool for malaria. The primary hematological abnormalities are thrombocytopenia and anemia, with P. falciparum causing greater abnormalities than P. vivax. Standard haematological tests have a useful diagnostic and prognostic role and aid in the early detection and good management of malaria.

Keywords: Malaria, Peripheral Blood Smear, Plasmodium vivax, Plasmodium falciparum, Thrombocytopenia, Anemia, Hematological Profile.