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

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 U-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 x10³cells/μL vs 268 x10³cells/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.

Keywords:

• adults
• malaria
• parasitemia level
• platelet parameters

Abbreviations

BF, Blood Film; EDTA, Ethylene Diamine Tetra Acetic Acid; Hgb, Hemoglobin; ICAM-1, Intravascular cell adhesion molecule-1; MPV, Mean Platelet Volume; NO, Nitric Oxide; PCT, Plateletcrit; PDW, Platelet Distribution Width; P-LCR, Platelet Large Cell Ratio; PF, Plasmodium Falciparum; PV, Plasmodium Vivax; TNFa, Tumor Necrosis Factor-alpha; VWF, Von Willebrand factor; WHO, World Health Organization.

Acknowledgments

We would like to express our heartfelt gratitude to the laboratory technicians and all staff members of Jinella Health Center for their unreserved support in blood sample collection, processing, and use of their laboratory facilities. In addition, we would also like to acknowledge the study participants and data collectors.

Author Contributions

All authors made a significant contribution to the work reported in the conception, study design, execution, acquisition, analysis, and interpretation of data; and took part in drafting, revising, and critically reviewing the manuscript. All authors have agreed on the approval of the final manuscript to be published in the current journal and to be accountable for all aspects of the work.

Disclosure

The authors declare that there is no conflict of interest regarding the publication of this paper.