Spectrum of Clinical and Hematological Changes Seen in Patients with Malaria: A Tertiary Care Hospital Based Study in Gujarat, India

This chapter aims to evaluate the spectrum of clinical and hematological changes in patients of malaria at a tertiary care hospital in Gujarat, India.

This retrospective study was conducted at Hematology laboratory, Pathology department, Sumandeep vidyapeeth, Vadodara. We included total 55 patients aged between 5 to 75 years with either gender. Demographic, clinical and laboratory data were recorded. Two mililitres blood was collected in EDTA vaccuttee and processed oncell counter SYSMEX KX-21. Thick and thin smears were prepared and stained with giemsa stain and leishman cytochrome stain. We used Epi info software for calculating various statistics.

We evaluated total of 55 patients with age ranging from 5 years to 75 years. Out of 55, 40(72.7%) were males and 15(27.3%) were females with male to female ratio was 2.6:1. PV 41(74.5%) constituted majority of the cases, followed by PF 12(21.8%) and mixed infection 2 (3.6%) type. Along with fever 55(100%), the most common clinical features were rigors and chills 34(61.8%) headache 26(47.2%), nausea and vomiting 20(36.3%) and splenomegaly 28(50.9%). We reported anemia in 34(61.8%) of malaria cases, out of these 34 cases maximum cases of anemia was seen in PF 11(91.6%), followed by PV 22(53.6%) and mixed infection 01(50%). Thrombocytopenia was seen in 42(76.4%) of malaria cases. Out of these 42 cases maximum cases was seen in PV 31(75.6%), followed by PF 9(75%) and mixed infection 0(0%). Leucocyte count was within reference range in majority of our cases 42(76.4%). Leucocytosis was present in 8(14.5%) and leucopenia in 5(9.1%) cases. Out of these, PF showed higher number of leucocytosis (8.3%), while PV showed higher cases of leucopenia, while both the cases of mixed infection showed normal TLC.

In cases of malaria, the most common clinical changes are fever with rigours and chills, headache, and splenomegaly, and the most common haematological changes are anaemia and thrombocytopenia. The presence of these classic images in a feverish patient aids in the early diagnosis of malaria. Early treatment can thus be introduced, and mortality as a result of complicated cases can be avoided in the long run.