Department of Public Health, College of Health Sciences Saudi Electronic University, Riyadh, Kingdom of Saudi Arabia.
Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan.
BMC Infect Dis. 2021 May 31;21(1):507. doi: 10.1186/s12879-021-06228-y.
Hematological abnormalities are common features in falciparum malaria but vary among different populations across countries. Therefore, we compared hematological indices and abnormalities between Plasmodium falciparum-infected patients and malaria-negative subjects in Kosti city of the White Nile State, Sudan.
A comparative, cross-sectional study was conducted at the Clinical Laboratory Unit of Kosti Teaching Hospital from June to December 2018. A total of 392 participants (192 P. falciparum-infected patients and 200 malaria-negative subjects) were recruited in the study. Hematological indices of hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets were measured, and their median values were statistically compared.
The majority of P. falciparum-infected patients (67.6%) showed a low-level parasitemia. The median values of Hb concentration, RBC count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were significantly lower in P. falciparum-infected patients, while the median red cell distribution width (RDW) was significantly higher in the patients compared to malaria-negative subjects. Anemia, low MCV, low MCH, low MCHC and high RDW were significantly associated with falciparum malaria, but parasitemia level was not significantly associated with anemia severity. The median total WBC count was non-significantly higher in P. falciparum-infected patients, with neutropenia being significantly associated with falciparum malaria. The median platelet count was significantly lower in P. falciparum-infected patients, with thrombocytopenia being significantly associated with falciparum malaria.
Falciparum malaria among patients in Kosti city of the White Nile State, Sudan is predominantly of low-level parasitemia. It is significantly associated with anemia, low MCV, low MCH, low MCHC, high RDW, thrombocytopenia and neutropenia. However, parasitemia level is not a significant predictor of anemia severity. On the other hand, leucopenia is not useful to predict falciparum malaria. Further large-scale studies in community and healthcare settings and inclusion of patients with complicated or severe malaria and those with high parasite densities are recommended.
血液学异常是恶性疟原虫感染的常见特征，但在不同国家的不同人群中存在差异。因此，我们比较了苏丹白尼罗河州科斯蒂市恶性疟原虫感染患者和疟原虫阴性对照者的血液学指标和异常情况。
这是一项在 2018 年 6 月至 12 月于科斯蒂教学医院检验科进行的比较性、横断面研究。共招募了 392 名参与者（192 名恶性疟原虫感染患者和 200 名疟原虫阴性对照者）。测量了血红蛋白（Hb）、红细胞（RBCs）、白细胞（WBCs）和血小板的血液学指数，并对其中位数进行了统计学比较。
大多数恶性疟原虫感染患者（67.6%）表现为低度寄生虫血症。与疟原虫阴性对照者相比，恶性疟原虫感染患者的 Hb 浓度、RBC 计数、平均红细胞体积（MCV）、平均红细胞 Hb（MCH）和平均红细胞 Hb 浓度（MCHC）中位数显著降低，而红细胞分布宽度（RDW）中位数显著升高。贫血、低 MCV、低 MCH、低 MCHC 和高 RDW 与恶性疟原虫感染显著相关，但寄生虫血症水平与贫血严重程度无显著相关性。恶性疟原虫感染患者的总 WBC 计数中位数显著升高，中性粒细胞减少与恶性疟原虫感染显著相关。恶性疟原虫感染患者的血小板计数中位数显著降低，血小板减少与恶性疟原虫感染显著相关。
苏丹白尼罗河州科斯蒂市的患者中，恶性疟原虫感染主要为低度寄生虫血症。它与贫血、低 MCV、低 MCH、低 MCHC、高 RDW、血小板减少和中性粒细胞减少显著相关，但寄生虫血症水平不是贫血严重程度的显著预测因子。另一方面，白细胞减少对预测恶性疟原虫感染没有用处。建议在社区和医疗机构进行更大规模的研究，并纳入病情复杂或严重的疟疾患者以及寄生虫密度高的患者。
