Study of Routine Hemogram And Serum Electrolytes (Na+, K+) Changes in Malaria Patients at Tertiary Care Hospital of Western India
Keywords:
Malaria, Anemia, Thrombocytopenia, Serum electrolytes
Abstract
Background: Malaria is still a major health problem accounting for more than 2 million lives around the globe. This study aims to assess the routine hemogram and serum electrolytes changes enabling early detection of malaria and thereby alerts the clinician to start early treatment. Methods: A total of 325 smear positive Malaria cases at indoor and outdoor patient departments of V.S. General Hospital, Ahmedabad were analyzed by performing complete blood count (CBC) in automated cell counter and serum electrolytes estimation in biochemistry analyzer. Results were analyzed for species specificity and compared with the other relevant studies. Results: P.Vivax cases (74.8%) were more common than P.falciparum cases (25.2%) with Male predominance. Anemia (80%) and thrombocytopenia (85.8%) were most significant findings in malaria patients in routine hemogram. Mean hemoglobin was 10.3 Gram/dl; Mean Total WBC count was 6314.8/cumm and Mean Platelet count was 89628.2/cumm. Serum electrolytes showed hyponatremia (59.7%), hypokalemia (29.9%) and hyperkalemia (20.6%). All these electrolyte derangements were found more common with P.falciparum cases. Conclusions: In patients presenting with fever, low hemoglobin and platelet count must trigger high index of suspicion of malaria. Serum electrolytes should be regularly monitored in all malaria positive cases as their derangements may indicate disease severity and timely correction of it may prevent deadly complications improving morbidity and mortality in high grade infections.References
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2. Kumar A. Thrombocytopenia--an indicator of acute vivax malaria. Indian journal of pathology & microbiology. 2006 Oct;49(4):505-8.
3. Joshi U, Solanki A, Oza U et al. Situation of P. vivax malaria in Ahmedabad city: a study in purview of national guidelines. Annals of Tropical Medicine and Public Health. 2013 Mar 1;6(2):227.
4. Warhurst DC, Williams JE. Laboratory procedures for diagnosis of malaria. InMalaria: a hematological perspective 2004 (pp. 1-27).
5. Abdalla SH, Pasvol G, editors. Malaria: A hematological perspective. Imperial College Press; 2004.
6. Newton PN, Essien E, White NJ. Platelets and blood coagulation in human malaria. InMalaria: A Hematological Perspective 2004 (pp. 249-276).
7. Agravat AH, Dhruva GA. Hematological changes in patients of malaria. Journal of Cell and Tissue Research. 2010 Dec 1;10(3):2325.
8. Akhtar S, Gumashta R, Mahore S, Maimoon S. Hematological changes in malaria: a comparative study. IOSR-JPBS. 2012;2:15-9.
9. Rao S. Hematological and biochemical alterations in malaria patients with clinical correlation in a tertiary care hospital. International journal of biological & medical research 2013; 4(2): 3139-142.
10. Gohil S, Mody P, Nimavat K. A Haematological profile of malaria patients in a tertiary care hospital of jamnagar district. Global journal for research analysis. Jun 2013; 2(6):181-83.
11. Thanachartwet V, Krudsood S, Tangpukdee N et al.. Hyponatraemia and hypokalaemia in adults with uncomplicated malaria in Thailand. Tropical doctor. 2008 Jul;38(3):155-7.
12. Dondorp, A., Nosten F, Stepniewska K, Day N., White N. South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet.2005 Aug 27-Sep 2;366(9487):717-725
13. English MC, Waruiru C, Lightowler C, Murphy SA, Kirigha G, Marsh K. Hyponatraemia and dehydration in severe malaria. Archives of disease in childhood. 1996 Mar 1;74(3):201-5.
14. Rajapurkar MM. Renal involvement in malaria. Journal of postgraduate medicine. 1994 Jul 1;40(3):132.
15. Dworak JA, Miller LH, Whitehouse WC, Shirosh T. Invasion of the electrolytes by the malaria parasite. Science. 1975;187:748-50.
16. Hanson J, Hossain A, Charunwatthana P et al. Hyponatremia in severe malaria: evidence for an appropriate anti-diuretic hormone response to hypovolemia. The American journal of tropical medicine and hygiene. 2009 Jan 1;80(1):141-5.
17. Ikekpeazu JE, Neboh EE, Aguchime NC, Maduka IC, Anyanwu EG. Malaria parasitaemia: effect on serum sodium and potassium levels. Biol Med. 2010; 2(2):20-5.
18. Jasani JH, Sancheti SM, Gheewala BS et al. Association of the electrolyte disturbances (Na+, K+) with the type and severity of the malarial parasitic infection. J Clin Diagn Res. 2012;6:678-81.
19. Maitland K, Pamba A, Newton CR, Levin M. Response to volume resuscitation in children with severe malaria. Pediatric critical care medicine. 2003 ;Oct 1;4(4):426-31.
Published
2018-08-22
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