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. 2016 Jun;40(2):303-11.
doi: 10.1007/s12639-014-0501-z. Epub 2014 Jul 27.

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

D S Squire  1 , R H Asmah  2 , C A Brown  2 , D N Adjei  2 , N Obeng-Nkrumah  3 , P F Ayeh-Kumi  3
Affiliations

Effect of Plasmodium falciparum malaria parasites on haematological parameters in Ghanaian children

D S Squire et al. J Parasit Dis. 2016 Jun.

Abstract

Malaria is hyper-endemic in Ghana. Haematological alterations in the disease pathology may offer complimentary criteria to improve clinical and microscopy diagnosis. Our primary outcome was to evaluate haematological parameters in children with Plasmodium falciparum infections and report their predictive risk and diagnostic performance for malaria infections in Ghana. Haematological data, including thin and thick blood films were examined for children less than 12 years of age in a multicenter-based active case finding approach. Haematological changes were common in P. falciparum infected children and more pronounced in severe malaria cases. More so, a unit increase in parasiteamia increased the odds for severe malaria infection by 93 % [OR, 95 % CI: 1.93 (1.28-2.91); P value = 0.02]. In multivariate regression, low haemoglobin was a significant haematological change in predicting P. falciparum infections [OR, 95 % CI: 3.20 (1.26-7.09); P value = 0.001]. Low haemoglobin levels <11 g/dl was the most reliable indicator for P. falciparum infections [with a sensitivity of (64 %), specificity (71 %), positive predictive value (83 %) and likelihood ratio (2.2)]-even when evaluated in combination with leucocytosis, lymphocytopaenia and high neutrophil counts >7,500 µL. In malaria endemic settings, low haemoglobin concentration (<11 g/dl) in children with febrile illness should prompt a more diligent search for the malarial parasite to limit the misuse and abuse of anti-malarial drugs.

Keywords: Malaria; Parasitaemia; Plasmodium falciparum; Severe; Uncomplicated.

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Figures

Fig. 1
Fig. 1
Profile of haemoglobin concentration in (a) all children, and (b) aneamic children across parasite densities in Ghanaian children infected with P. falciparum. Haemoglobin (Y-axis, g/dl) by parasiteamia ×103 µL (X-axis) with Tricube kernel smooth fit line generated with local polynomial regression at 60 % of points to fit
Fig. 2
Fig. 2
Haemoglobin versus age distribution of (a) P. falciparum infected and (b) non-malaria infected aneamic children with Tricube kernel smooth fit line generated with local polynomial regression at 60 % of points to fit
See this image and copyright information in PMC

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