Background: Malaria is a major health problem and one of the major killers in paediatric population particularly in the developing world. High mortality is usually compounded by various haematological complications if left untreated. Their identification as risk factors for progression to severe disease may make the basis for optimal management of malaria. This study was conducted to determine various changes in the complete blood picture caused by malaria and to compare the severity of these changes among the prevalent species of plasmodia.
Methods: It was cross sectional study conducted in paediatric ward of Civil Hospital, Dow University of Health Sciences, Karachi over a period of six months. Children aged >2 months to 15 years, of either sex, with fever above 101 degrees F in the preceding 72 hours with positive malaria parasite on peripheral blood smear were included in the study. Children already on anti-malarial. treatment and long standing antibiotics, having co-morbidities like immune-compromised states, haemolytic disease or with any other haematological disorder were excluded from the study. Blood was tested for anaemia, leukopenia, leukocytosis, and thrombocytopenia. Data analysis was done via SPSS-15.0.
Results: Out of 374 children half were under 5 years of age with mean age of 66.7 +/- 46.8 months, 50.8% were female with male to female ratio of 1:1.03. Overall 364 (97.3%) children had anaemia with mean haemoglobin level of 11.7 +/- 6 g/dl. Overall mean WBC count was 10443 +/- 154 per cubic millimetre. Leukopenia was found in 39% cases. Mean platelets count of enrolled children was 69451 +/- 648 cubic millimetre and 51.3% cases had mild thrombocytopenia. Anaemia (p=0.012), leukopenia (p=0.001) and thrombocytopenia (p=0.004) were significantly more common in falciparum as compared to vivax malaria.
Conclusion: We concluded that malaria frequently causes severe anaemia, leukopenia and thrombocytopenia in children. P. falciparum is the species more responsible for these changes.