Characterization of platelet count and platelet indices and their potential role to predict severity in malaria

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Abstract

The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1%) had severe malaria. 116 (73%) had infection with P. vivax, 37 (23%) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4%) of P. falciparum and 105 (90.5%) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm had a sensitivity and specificity of 65.6% and 70.6% respectively, to discriminate severe malaria. A plateletcrit of 0.05% had a sensitivity and specificity of 65.6 % and of 70.6% respectively. Thrombocytopenia was seen in 89.3% of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as ‘benign’ can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided.

Original languageEnglish
Pages (from-to)86-93
Number of pages8
JournalPathogens and Global Health
Volume113
Issue number2
DOIs
Publication statusPublished - 17-02-2019

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Platelet Count
Malaria
Blood Platelets
Thrombocytopenia
Sensitivity and Specificity
Platelet Transfusion
Viperidae
Coinfection
Renal Insufficiency
Liver Diseases
India
Shock
Infection

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Microbiology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

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title = "Characterization of platelet count and platelet indices and their potential role to predict severity in malaria",
abstract = "The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1{\%}) had severe malaria. 116 (73{\%}) had infection with P. vivax, 37 (23{\%}) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4{\%}) of P. falciparum and 105 (90.5{\%}) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm 3  had a sensitivity and specificity of 65.6{\%} and 70.6{\%} respectively, to discriminate severe malaria. A plateletcrit of 0.05{\%} had a sensitivity and specificity of 65.6 {\%} and of 70.6{\%} respectively. Thrombocytopenia was seen in 89.3{\%} of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as ‘benign’ can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided.",
author = "Pranjal Gupta and Vasudev Guddattu and Kavitha Saravu",
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AU - Guddattu, Vasudev

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N2 - The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1%) had severe malaria. 116 (73%) had infection with P. vivax, 37 (23%) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4%) of P. falciparum and 105 (90.5%) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm 3  had a sensitivity and specificity of 65.6% and 70.6% respectively, to discriminate severe malaria. A plateletcrit of 0.05% had a sensitivity and specificity of 65.6 % and of 70.6% respectively. Thrombocytopenia was seen in 89.3% of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as ‘benign’ can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided.

AB - The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1%) had severe malaria. 116 (73%) had infection with P. vivax, 37 (23%) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4%) of P. falciparum and 105 (90.5%) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm 3  had a sensitivity and specificity of 65.6% and 70.6% respectively, to discriminate severe malaria. A plateletcrit of 0.05% had a sensitivity and specificity of 65.6 % and of 70.6% respectively. Thrombocytopenia was seen in 89.3% of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as ‘benign’ can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided.

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