Biochemical characteristics of Malaria patients with their association with severity of disease
Abstract
Malaria is one of the oldest and most widespread disease which affects more than 2400 million people, over 40% of world's population, in more than 100 countries in tropics from South America to Indian Peninsula. This study was designed to assess the platelet counts, haematocrit & liver enzymes (Alanine transaminase, Aspartate transaminase, Alkaline phosphatase) in patients of Plasmodium vivax & Plasmodium falciparum malaria and its association with the severity and prognosis of disease. In a hospital based observational descriptive study, 100 patients with Plasmodium falciparum and/or vivax positive diagnosed by peripheral blood film examination and/or by MPQBC (Malaria Parasite Quantitative Buffy Coat) method were included and submitted to a complete clinical & laboratory evaluation. Patients who were ≤ 14 years and who refused to give consent were excluded. They were divided into Plasmodium vivax and Plasmodium falciparum positive group; evaluated, compared and statistical analysis done. Out of total 100 cases of malaria positive, P. falciparum constituted 66% and P. vivax constituted 34%. The pathophysiological processes causing the haematological changes in malaria are complex and multiple. Thrombocytopenia presents with bleeding manifestations and it increases the severity of disease with poor prognosis.
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Introduction
Malaria is one of the oldest and most widespread diseases in the world which affects more than 2400 million people, over 40% of world's population, in more than 100 countries in tropics from South America to Indian Peninsula. 1, 2 Malaria ranks third among the major infectious disease in causing death after pneumococcal acute respiratory infection and tuberculosis. The term 'malaria' has been derived from Italian description meaning - Bad Air. 2
Malaria in man is caused by four distinct species of the malaria parasite - P. vivax, P. falciparum, P. malariae and P. ovale. P. vivax has the widest geographic distribution. In India, about 70% of the infections are reported to be due to P. vivax; 25-30% due to P. falciparum and 4-8% due to mixed infection. 3
The classic presentation of malaria consists of paroxysms of fever alternating with periods of fatigue. Symptoms associated with febrile paroxysms include high grade fever, chills, rigor, sweat, headache, myalgia, back pain, abdominal pain, nausea, vomiting, diarrhea, pallor and jaundice. Paroxysms coincide with rupture of RBC laden with Schizonts that occur every 48 hour with P. vivax resulting in alternate day fever spikes. Periodicity is less apparent with P. falciparum and mixed infections. 4, 5
Conclusion
This present study concludes that the patho-physiological processes causing the haematological changes in malaria are complex and multiple. Thrombocytopenia presents with bleeding manifestations and it increases the severity of disease with poor prognosis. Hepatitis is also found with Malaria. The So malaria case should be treated at earliest to prevent various complications associated with this.