Haematological profile and its outcome in different species of malaria: a two year study


  • Usham Gangaram Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Malli Dorasanamma Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Giri Raju Sarikonda Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India
  • Tupili Ramya Department of Microbiology, Narayana Medical College, Nellore, Andhra Pradesh, India




Different species, Hematological profile, Malaria, Outcome, Severe anemia, Thrombocytopenia


Background: Malaria is a major health problem in many parts of India and some parts of Andhra Pradesh, which is also one of the endemic areas for malaria. Several factors have been attributed to increased morbidity and mortality in malaria especially with altered hematological and coagulation parameters playing an important role. The aim of present study was to study the hematological and coagulation abnormalities that correspond to severity and the final outcome.

Methods: The present study was    carried out on 100    patients admitted during the period of November 2016 to October 2018 at Narayana Medical College and hospital, Nellore. All of these patients were confirmed by Peripheral Smear or MPQBC or Antigen Assay   followed by detailed clinical history, physical examination and investigated with hematological and coagulation parameters. Then subsequently required routine and special investigation which was followed by monitoring the outcome of the patients with respect to morbidity and mortality.

Results: Out of 100 patients 20 patients had severe anemia (Hb% <7 gm%) and most of them patients were falciparum and mixed infection cases. Thrombocytopenia was observed in 63% of the patients and severe thrombocytopenia (<50,000 mm3) was seen in 12% of the patients. PT and APTT were increased in 18% and 13% of the cases respectively. BT was increased in 5% of the cases.  None of the patients expired in this study.

Conclusions: severe anemia is a poor prognostic factor and has adverse outcome. Thrombocytopenia, increased PT, APTT does not have any correlation to mortality.


Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrisons Principles of Internal Medicine. In: White NJ, Ashley EA. Malaria. 20th Edi., McGraw-Hill; 1576-1578.

Bruce-Chwatt LJ. Essential Malariology, 3rd Ed., Edward Arnold, Boston; 1993:208-218.

Facer CA. Hematological aspect of malaria In: Infection and Hematology. Oxford Butterworth Heinemann Ltd.; 1994:259-294.

Murphy GS, Old feild EC. Falciparum malaria. Inf Dis Clin North Am. 1996;10:747-75.

Jandle JH. Hemolytic anemias caused by infection of red blood cells. In: Blood. 2nd edition. New York: Little brown and company; 1996:473-501.

White NJ. Malaria. Lancet. 2014;383(9918):723-35.

Tobón-Castaño A, Mesa-Echeverry E, Miranda-Arboleda AF. Leukogram profile and clinical status in vivax and falciparum malaria patients from Colombia. J Tropic Med. 2015;2015.

Arévalo-Herrera M, Lopez-Perez M, Medina L, Moreno A, Gutierrez JB, Herrera S. Clinical profile of Plasmodium falciparum and Plasmodium vivax infections in low and unstable malaria transmission settings of Colombia. Malaria J. 2015 Dec 1;14(1):154.

Surve KM, Kulkarni AS, Rathod SG, Bindu RS. Study of haematological parameters in malaria. Inter J Res Med Sci. 2017 Jun;5(6):2552-7.

Yadav RK, Kumar S. To study hematological profile in malaria patients. Inter J Adv Med. 2017 May;4(3):707-12.

Vaidya MS, Kawale JB, Maheshkar PR, Kamble AN. A comparative study of hematological profile on presentation in confirmed cases of malaria, dengue and leptospirosisl. Int J Res Med Sci. 2018 Feb;6(2):472-80.

Rathod SN, Chavan A, Sharma S, Rathod T, Khan N, Bavdhankar K. Changing clinical profile of malaria at a tertiary care hospital. Int J Adv Med. 2018 May;5:510-3.

Patel GI, Muley P, Vadher A, Suthar PP, Shah GV, Patel AB. A comparative study of clinical, biochemical and hematological profiles in smear positive malaria patients: at a tertiary care center located in rural part of Gujarat, India. Int J Res Med Sci. 2015 Oct;3:2561-6.

Khuraiya P, Sharma SS, Thakur AS, Pandey VP, Verma S. The study of clinical, biochemical and hematological profile in malaria patients. Int J Adv Med. 2016 Apr;3(2):209-17.

Charulata SL, Londhey VA, Nabar ST. The Study of Complications of Vivax Malaria in Comparison with Falciparum Malaria in Mumbai. JAPI. 2012;(60):15-8.

Kini RG, Chandrashekhar J. Parasite and the Circulating Pool-Characterisation of Leukocyte Number and Morphology in Malaria. Journal of clinical and diagnostic research: JCDR. 2016 May;10(5):EC44-8.

Halim NK, Ajayi OI, Oluwafemi F. Monocytosis in acute malaria infection. Nigerian J Clini Pract. 2002;5(2):106-8.

Horstmann RD, Dietrich M, Bienzle U, Rasche H. Malaria-induced thrombocytopenia. Blut. 1981; 42(3):157-64.

Kuch. Hematological alterations in acute malaria. Scandanavian J Haematol. 1982;29(2):147.

Rao SV, Jirwankar PS, Sonavani MV, Bindu RS, Dubbe VH. Clinical profile and prognostic factors of severe falciparum malaria in a tertiary care hospital. The Journal of the Association of Physicians of India. 2013 Oct;61(10):769.

Melhotra B. Haematological manifestation of Malaria. Indian J Haematol Blood Transfusion. 1997:15-40

Jayashankar CA, Pinnelli VB , Ramya P. Alteration of coagulation profile in malaria patients and its correlation with degree of parasitemia: a prospective study. Int J Adv Med. 2016 May;3(2):388-92.

Kashinkunti M, Alevoor S. Clinical, hematological and coagulation profile in malaria. Sch J Appl Med Sci. 2014;2:584-8.

Roy S. Hematological profile in Patients with acute falciparum malaria. JAPI. 2002

Clemens R, Pramoolsinsap C, Lorenz R, Pukrittayakamee S, Bock HL, White NJ. Activation of the coagulation cascade in severe falciparum malaria through the intrinsic pathway. Brit J Haematol. 1994 May;87(1):100-5.

Sharma SK, Das RK, Das BK, Das PK. Haematological and coagulation profile in acute falciparum malaria. J Assoc Physicians India. 1992 Sep;40(9):581-3.

Sen R, Tewari AD, Sehgal PK, Singh U, Sikka R, Sen J. Clinico-haematological profile in acute and chronic Plasmodium falciparum malaria in children. J Communicable Dis. 1994 Mar;26(1):31-8.






Original Research Articles