Zniber Nabil Mohamed, Laatiris Hamid, Siyar Hamza, Erraji Abdelouahab, Labrouzi Ismail, Jnah Mohamed, Talbi Mehdi, Iken Maryem, Lmimouni Badreddine, Naoui Hafida
Department of Parasitology and Mycology, Mohamed V Military Instruction Hospital, Rabat, Morocco.
Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco.
Access Microbiol. 2025 May 21;7(5). doi: 10.1099/acmi.0.000919.v3. eCollection 2025.
Malaria remains a significant global health concern, particularly in travellers returning from endemic regions. Haematological abnormalities are often associated with malaria and can serve as diagnostic indicators, especially when clinical symptoms are nonspecific. This study aims to identify the most relevant haematological parameters for diagnosing malaria in travellers returning from endemic areas, who sought care at the Mohamed V Military Instruction Hospital in Rabat. We conducted a retrospective comparative study involving 829 patients who returned from malaria-endemic regions between January 2017 and December 2023. Data collected included demographic information, parasitological test results and comprehensive haematological profiles. Statistical analysis was performed to determine the sensitivity and specificity of various haematological parameters in diagnosing malaria. Thrombocytopenia, lymphocytopenia and anaemia were the most significant haematological abnormalities associated with malaria. Thrombocytopenia, defined as a platelet count below 150×10³ µl, demonstrated a sensitivity of 75.91% and a specificity of 84.11%. Lymphocytopenia, with a threshold of less than 1.5×10³ µl, showed a sensitivity of 69.47% and a specificity of 78.39%. Anaemia, defined by haemoglobin levels below 13 g dl in men and 12 g dl in women, also significantly correlated with malaria diagnosis. This study highlights the significance of haematological abnormalities as key diagnostic markers for imported malaria cases. By analysing retrospective data, we observed that these abnormalities, especially thrombocytopenia and anaemia, are common amongst returning travellers with confirmed malaria. These findings suggest that clinicians can use such markers as a valuable tool for early malaria diagnosis, potentially improving patient outcomes. Additionally, the study reinforces the need for heightened awareness amongst healthcare providers in non-endemic regions regarding the presentation of malaria in travellers. Haematological parameters such as thrombocytopenia, lymphocytopenia and anaemia are valuable diagnostic tools for malaria in returning travellers. These findings suggest that these parameters should be integrated into diagnostic protocols to improve the accuracy and timeliness of malaria diagnosis, particularly in clinical settings with limited access to advanced diagnostic tools.
疟疾仍然是一个重大的全球健康问题，尤其是在从流行地区返回的旅行者中。血液学异常常与疟疾相关，可作为诊断指标，特别是在临床症状不具特异性时。本研究旨在确定在拉巴特穆罕默德五世军事教学医院就诊的、从流行地区返回的旅行者中，用于诊断疟疾的最相关血液学参数。我们进行了一项回顾性比较研究，涉及2017年1月至2023年12月期间从疟疾流行地区返回的829名患者。收集的数据包括人口统计学信息、寄生虫学检测结果和全面的血液学概况。进行统计分析以确定各种血液学参数在诊断疟疾中的敏感性和特异性。血小板减少、淋巴细胞减少和贫血是与疟疾相关的最显著血液学异常。血小板减少定义为血小板计数低于150×10³µl，其敏感性为75.91%，特异性为84.11%。淋巴细胞减少的阈值低于1.5×10³µl，敏感性为69.47%，特异性为78.39%。贫血定义为男性血红蛋白水平低于13 g dl，女性低于12 g dl，也与疟疾诊断显著相关。本研究强调了血液学异常作为输入性疟疾病例关键诊断标志物的重要性。通过分析回顾性数据，我们观察到这些异常，尤其是血小板减少和贫血，在确诊疟疾的返回旅行者中很常见。这些发现表明，临床医生可以将这些标志物作为早期疟疾诊断的有价值工具，可能改善患者预后。此外，该研究强化了非流行地区医疗保健提供者提高对旅行者疟疾表现认识的必要性。血小板减少、淋巴细胞减少和贫血等血液学参数是返回旅行者疟疾的有价值诊断工具。这些发现表明，这些参数应纳入诊断方案，以提高疟疾诊断的准确性和及时性，特别是在难以获得先进诊断工具的临床环境中。
