A Study on Prognostic Value of Thrombocytopenia in Falciparum Malaria in Jharkhand
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 11
Abstract
Introduction: Falciparum malaria accounts for most of the deaths amongst the malaria cases. Severe falciparum malaria is infact a medical emergency and requires immediate management and intensive nursing care. It is prone to complications such as cerebral malaria, hypoglycaemia, acidosis, renal impairement, liver dysfunction etc. The haematological abnormalities that may be seen in P. falciparum malaria are anemia and thrombocytopenia. Thrombocytopenia could be an early marker of disease severity. The aim of our study was to study the incidence and prognostic value of thrombocytopenia in Plasmodium falciparum malaria. Material and Method: This was an prospective observational study done on 80 admitted patients of falciparum malaria in Department of Medicine, Rajendra institute of medical science, Ranchi, Jharkhand. Results: The total no. of case studied were 80(n=80). The mean age of patients were 34.72 ± 12.54 years. Majority of the cases (64) were seen in age group 20 -50 years (80%). On seeing the sex distribution, total no. of cases among male patients were 60(75%) and amongst females were 20(25%), no. of males was more than females. Majority of the cases were from rural areas 57(71.25%) as compared to urban areas 23(28.75%) which may be due to poverty, lack of proper education and living in unhygienic conditions. 31.25% of the patients (25) were tribal and 68.75 % (55) were non-tribals. Mild thrombocytopenia was seen in 16 patients (35.56%) of complicated malaria as compared to 15 patients (42.86%) of uncomplicated malaria. Moderate thrombocytopenia is seen in 22 patients (48.89%) of complicated cases as compared to 08 patients (22.86%) of uncomplicated malaria cases. Severe thrombocytopenia was observed in 06 patients, all patients (13.33%) were having complicated malaria and no patients of uncomplicated malaria had severe thrombocytopenia. Conclusion: Amongst the various markers of falciparum malaria such as jaundice, anemia, splenomegaly, thrombocytopenia has emerged as the strongest predictor of falciparum malaria. The sensitivity of thrombocytopenia together with acute febrile syndrome was almost 100% for malarial diagnosis. Overall incidence of thrombocytopenia with falciparum malaria was 83.75%. Thromobocytopenia manifests before even anemia and splenomegaly sets in. Thus, it could help in early diagnosis of falciparum malaria so that antimalarial drugs could be initiated in time saving many lives. Thrombocytopenia is a marker of severe disease in falciparum malaria.
Authors and Affiliations
Manmeet Topno
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