Objective:
1. To study the spectrum of changes in haematological and coagulation parameters in patients of
malaria.
2. To determine the prevalence of anaemia, thrombocytopenia and disseminated intra –vascular
coagulation in malaria patients.
3. To correlate the severity of malaria with haematological and coagulation dysfunction.
4. To note, if any, species-specific haematological and coagulation changes exist
Materials and Methods:
The present study was conducted in tertiary care centre in India. The study was carried out on 100 patients admitted during the period from June 2020 to October 2022 in the hospital. It was a prospective observational study. A detailed history was taken followed by a thorough clinical examination to assess clinical severity and complications. All the patients in this study were confirmed cases of malaria either by Peripheral smear examination (both thick and thin smear) or malaria rapid antigen test. These investigations were ordered before the antimalarial treatment was started.
Results:
In this prospective study of 1 0 0 patients withwithfever who were proven to have malaria either by Peripheralsmearorantigenassay; Anemia was seen in 88%ofthe total patients, severe anemia was seen in 17% of the patients. Severe anemia (Hb < 8 gm%) was more common in falciparum and mixed infection. Thrombocytopenia is common in almost all species of malaria. It was seen in 72% of total patients. PT was increased in 22% of the cases and APTT was increased in14% of the cases who had moderate to severe thrombocytopenia. BT was increased in 5% of the patients and 4% had bleeding manifestations.
Conclusions:
Anemia is an important complication and cause of high morbidity and mortality in acute malaria and its severity correlates with high parasitemia. Hb <8 gm% is a poor prognostic factor. Bleeding manifestations are not commonly seen even in severe complicated falciparum malaria. Elevated values of PT, aPTT, FDP, D-dimer and BT, indicating activation of coagulation cascade and consumptive coagulopathy may lead to fatal outcome. Deaths in malaria are mainly due to P falciparum and mixed infection and are attributable to severe anemia, hyperparasitemia, intravascular coagulopathy and multi organ dysfunction
