Correlation of Presence and Severity of Thrombocytopenia with Types and Severity of Malaria: A study from tertiary care center of North India

BACKGROUND: Malaria is a major public health problem in India. Malaria is commonly associated with thrombocytopenia, but its significance is not well established. A prospective study was conducted to correlate the presence and severity of thrombocytopenia with types and severity of malaria. MATERIAL AND METHODS: This prospective observational study was performed in the Department of General Medicine at a tertiary care center of north India from January 2019 to June 2020. A total of 100 adult patients found positive for malaria parasites on peripheral smear examination were enrolled for the analysis. RESULTS: The incidence of thrombocytopenia was seen in 80% of total malaria patients. There was a significant (P = 0.0001) association of severity of thrombocytopenia with symptoms and signs of malaria except for rigor. There was no significant (P > 0.05) association of severity of thrombocytopenia with age. There was a significant (P = 0.003) association of severity of thrombocytopenia with M antigen. The analysis of variance showed that there was a significant (P = 0.0001) difference in Lung Function Test (LFT) and Kidney Function Test (KFT) parameters with severity of thrombocytopenia; whereas in blood parameters, only red blood cell counts were associated significantly with the severity of thrombocytopenia. CONCLUSION: Thrombocytopenia is a frequent overall manifestation of both falciparum and vivax malaria. Severe thrombocytopenia is identified in all age groups, commonly in males, and increases the risk of death from falciparum or vivax malaria, particularly in those with concurrent severe anemia. Early diagnosis and prompt treatment of malaria reduces the complications and adverse outcomes of the disease.