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埃塞俄比亚东部哈勒尔金内拉健康中心疟疾感染成年患者的血小板参数及其与疟原虫血症水平的相关性:比较横断面研究

Platelet Parameters and Their Correlation with Parasitemia Levels Among Malaria Infected Adult Patients at Jinella Health Center, Harar, Eastern Ethiopia: Comparative Cross-Sectional Study.

作者信息

Asmerom Haftu, Gemechu Kabtamu, Bete Tilahun, Sileshi Beza, Gebremichael Berhe, Walle Muluken, Arkew Mesay

机构信息

School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

School of Nursing and Midwifery, Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

J Blood Med. 2023 Jan 19;14:25-36. doi: 10.2147/JBM.S394704. eCollection 2023.

Abstract

BACKGROUND

Malaria is a major public health problem with the highest morbidity and mortality in developing countries. Hematological changes play a great role in malaria pathogenesis through platelets and platelet parameters. However, the changes in platelet parameters are not clearly described in Ethiopia. Therefore, this study aimed to compare platelet parameters and their correlation with parasitemia among malaria-infected adult patients and healthy adults.

METHODS

An institutional-based comparative cross-sectional study was conducted involving 186 (93 malaria-infected patients and 93 healthy adults) study participants using a convenient sampling technique at Jinella health center, Harar, Eastern Ethiopia, from July 10-August 10, 2022. Five milliliters of venous blood were collected from each study participant, and platelet parameters were analyzed using a Unicel (DxH 800) automated hematologic analyzer. A drop of blood was taken from malaria-suspected patients for blood film preparation. Results between two groups were compared using the Mann-Whitney -test. Spearman's rank correlation coefficient was used to evaluate the relationships between two continuous variables. A P-value of < 0.05 was considered statistically significant.

RESULTS

Platelet, plateletcrit, and mean platelet volume of malaria-infected patients were significantly lower as compared with healthy adults (103 x10cells/μL vs 268 x10cells/μL, 0.13 fl vs 0.23 fl, and 9.6 fl vs 15.3 fl), respectively). Conversely, platelet distribution width and platelet large cell ratio were higher in malaria-infected patients than healthy adults (19.2% vs 15.3% and 0.35% vs 0.29%), respectively). Parasitemia levels had a moderately inverse correlation with platelet count (r= -0.419) and a weakly positive correlation with mean platelet volume (r=0.278).

CONCLUSION

The platelet, plateletcrit, and mean platelet volume of malaria-infected patients were significantly lower as compared with healthy adults. Malaria parasitemia had a moderate inverse correlation with platelet count and a weak positive correlation with mean platelet volume. Thrombocytopenia and alteration of platelet parameters should be considered in malaria patients.

摘要

背景

疟疾是一个主要的公共卫生问题,在发展中国家发病率和死亡率最高。血液学变化通过血小板和血小板参数在疟疾发病机制中起重要作用。然而,埃塞俄比亚尚未明确描述血小板参数的变化。因此,本研究旨在比较疟疾感染成年患者和健康成年人的血小板参数及其与寄生虫血症的相关性。

方法

2022年7月10日至8月10日,在埃塞俄比亚东部哈勒尔的吉内拉健康中心,采用方便抽样技术对186名研究参与者(93名疟疾感染患者和93名健康成年人)进行了一项基于机构的比较横断面研究。从每位研究参与者采集5毫升静脉血,使用Unicel(DxH 800)自动血液分析仪分析血小板参数。从疑似疟疾患者采集一滴血制作血涂片。使用曼-惠特尼检验比较两组结果。采用Spearman等级相关系数评估两个连续变量之间的关系。P值<0.05被认为具有统计学意义。

结果

与健康成年人相比,疟疾感染患者的血小板、血小板压积和平均血小板体积显著降低(分别为103×10⁹个细胞/微升对268×10⁹个细胞/微升、0.13飞升对0.23飞升、9.6飞升对15.3飞升)。相反,疟疾感染患者的血小板分布宽度和血小板大细胞比率高于健康成年人(分别为19.2%对15.3%和0.35%对0.29%)。寄生虫血症水平与血小板计数呈中度负相关(r = -0.419),与平均血小板体积呈弱正相关(r = 0.278)。

结论

与健康成年人相比,疟疾感染患者的血小板、血小板压积和平均血小板体积显著降低。疟疾寄生虫血症与血小板计数呈中度负相关,与平均血小板体积呈弱正相关。疟疾患者应考虑血小板减少和血小板参数改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e82e/9869896/1c2fbe6a4186/JBM-14-25-g0001.jpg

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