Kotepui Manas, Phunphuech Bhukdee, Phiwklam Nuoil, Chupeerach Chaowanee, Duangmano Suwit
Medical Technology Programme, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat 80161, Thailand.
Malar J. 2014 Jun 5;13:218. doi: 10.1186/1475-2875-13-218.
Malaria is a major mosquito-borne public health problem in Thailand with varied haematological consequences. The study sought to elucidate the haematological changes in people who suspected malaria infection and their possible predictive values of malaria infection.
Haematological parameters of 4,985 patients, including 703 malaria-infected and 4,282 non-malaria infected, who admitted at Phop Phra Hospital, Tak Province, an area of malaria endemic transmission in Thailand during 2009 were evaluated.
The following parameters were significantly lower in malaria-infected patients; red blood cells (RBCs) count, haemoglobin (Hb), platelets count, white blood cells (WBCs) count, neutrophil, monocyte, lymphocyte and eosinophil counts, while mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), Mean corpuscular haemoglobin concentration (MCHC), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR) were higher in comparison to non-malaria infected patients. Patients with platelet counts < 150,000/uL were 31.8 times (odds ratio) more likely to have a malaria infection. Thrombocytopenia was present in 84.9% of malaria-infected patients and was independent of age, gender and nationality (P value < 0.0001).
Patients infected with malaria exhibited important changes in most of haematological parameters with low platelet, WBCs, and lymphocyte counts being the most important predictors of malaria infection. When used in combination with other clinical and microscopy methods, these parameters could improve malaria diagnosis and treatment.
疟疾是泰国主要的蚊媒传播公共卫生问题,会导致多种血液学后果。本研究旨在阐明疑似疟疾感染人群的血液学变化及其对疟疾感染的可能预测价值。
对2009年泰国疟疾流行传播地区达府佛丕医院收治的4985例患者的血液学参数进行了评估,其中包括703例疟疾感染患者和4282例非疟疾感染患者。
疟疾感染患者的以下参数显著较低:红细胞(RBC)计数、血红蛋白(Hb)、血小板计数、白细胞(WBC)计数、中性粒细胞、单核细胞、淋巴细胞和嗜酸性粒细胞计数;而与非疟疾感染患者相比,平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、中性粒细胞与淋巴细胞比值(NLR)和单核细胞与淋巴细胞比值(MLR)较高。血小板计数<150,000/μL的患者感染疟疾的可能性是(比值比)31.8倍。84.9%的疟疾感染患者存在血小板减少症,且与年龄、性别和国籍无关(P值<0.0001)。
感染疟疾的患者在大多数血液学参数上表现出重要变化,血小板、白细胞和淋巴细胞计数低是疟疾感染的最重要预测指标。当与其他临床和显微镜检查方法结合使用时,这些参数可改善疟疾的诊断和治疗。