Bansal Yashik, Maurya Vinod, Aggarwal Nidhima, Tak Vibhor, Nag Vijaya Lakshmi, Purohit Abhishek, Goel Akhil Dhanesh, Bohra Gopal Krishna, Singh Kuldeep
Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Trop Parasitol. 2020 Jul-Dec;10(2):95-101. doi: 10.4103/tp.TP_68_19. Epub 2021 Jan 25.
The arid climate of Western Rajasthan is challenging for malaria transmission, with the number of cases correlating directly with the annual rainfall pattern. Moreover, >90% of the cases in this region are caused by , which has recently been shown to cause a similar degree of thrombocytopenia as .
The aim of the study was to determine the degree of thrombocytopenia in malaria patients and its association with different species of malaria in this region with an unstable malaria epidemiology.
This retrospective study was conducted on all microbiologically confirmed malaria patients with documented platelet counts from August 2017 to October 2018. Microbiological diagnosis was established by rapid diagnostic tests and peripheral blood film examination. Platelet counts were used to assess the degree of thrombocytopenia.
A total of 130 cases were included in the study, of which 118 (91%) were caused by P. vivax, while the rest 12 (9%) were caused by . Thrombocytopenia was present in 108 (83%) cases, and the mean values of platelets in thrombocytopenic patients with and infection were 72600/μL and 48500/μL, respectively. Although infection was significantly associated with severe thrombocytopenia (odds ratio: 4.7, [95% confidence interval 1.3-16.1]), extremely low platelet counts ( = 5) warranting platelet transfusions ( = 1) were seen only in cases. Only one patient required platelet transfusions in these patients suggesting good tolerance to thrombocytopenia.
Avoiding unnecessary transfusions in febrile thrombocytopenic patients with an established malaria diagnosis can help in reducing transfusion-transmitted infections.
拉贾斯坦邦西部的干旱气候对疟疾传播构成挑战，病例数量与年降雨模式直接相关。此外，该地区90%以上的病例由[某种疟原虫]引起，最近研究表明，[该疟原虫]导致的血小板减少程度与[另一种疟原虫]相似。
本研究旨在确定疟疾流行不稳定地区疟疾患者的血小板减少程度及其与不同疟原虫种类的关联。
本回顾性研究针对2017年8月至2018年10月所有微生物学确诊且有血小板计数记录的疟疾患者。通过快速诊断试验和外周血涂片检查进行微生物学诊断。用血小板计数评估血小板减少程度。
本研究共纳入130例病例，其中118例（91%）由间日疟原虫引起，其余12例（9%）由[另一种疟原虫]引起。108例（83%）存在血小板减少，感染[某种疟原虫]和[另一种疟原虫]的血小板减少患者的血小板平均值分别为每微升72600个和48500个。虽然感染[某种疟原虫]与严重血小板减少显著相关（比值比：4.7，[95%置信区间1.3 - 16.1]），但极低血小板计数（n = 5）需要输血（n = 1）仅在[某种疟原虫]感染病例中出现。这些患者中仅1例需要输血，提示对血小板减少耐受性良好。
对于已确诊疟疾的发热性血小板减少患者，避免不必要的输血有助于减少输血传播感染。
