Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan
Background: Malaria continues to be a major public health problem in India. Vivax malaria is being increasingly seen with thrombocytopenia. The reported prevalence of the same has been extremely variable and its significance is not well established. This study was conducted to ascertain the prevalen...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Journal of Marine Medical Society |
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| Online Access: | https://journals.lww.com/10.4103/jmms.jmms_97_24 |
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| author | Sudhir Sudhakar Khune V S Shrikanth Biju M. John |
| author_facet | Sudhir Sudhakar Khune V S Shrikanth Biju M. John |
| author_sort | Sudhir Sudhakar Khune |
| collection | DOAJ |
| description | Background:
Malaria continues to be a major public health problem in India. Vivax malaria is being increasingly seen with thrombocytopenia. The reported prevalence of the same has been extremely variable and its significance is not well established. This study was conducted to ascertain the prevalence and severity of thrombocytopenia in vivax malaria and assess the outcome of cases with severe thrombocytopenia. A secondary objective was to compare the clinical and laboratory profile of cases of vivax malaria with falciparum malaria and mixed infection.
Materials and Methods:
This hospital-based prospective study was carried out in the department of general medicine at a sub-zonal hospital in Western Rajasthan in the year 2022. Consecutive febrile patients with a diagnosis of malaria were included in the study after ruling out coexistent alternate infections.
Results:
A total of 396 cases were enrolled. Ninety-nine percent of patients were male. The mean age of the study group was 32.1 years. A total of 328 (90.8%) out of 361 vivax malaria cases had thrombocytopenia (platelet count <150 × 103 μL) with 26.5% having severe thrombocytopenia (platelet count <50 × 103 μL). The mean defervescence duration was 44.4 h in vivax malaria. 3.4% of severe vivax malaria cases required intensive care unit care due to hypotension, respiratory distress, and multiorgan dysfunction, and none of them had any bleeding manifestations. All cases recovered well after standard treatment. There was a significant statistical difference between the mean platelet count among the three types of malaria: vivax, falciparum, and mixed (vivax + falciparum infections) (P = 0.03). Similarly, on applying Chi-square test, there was a significant difference in severe thrombocytopenia across the groups (P = 0.01).
Conclusion:
There is a high prevalence of thrombocytopenia in vivax malaria including severe thrombocytopenia. In the majority of cases, this thrombocytopenia does not result in any adverse event, and cases respond well to conventional treatment. Clinicians need to be aware of the extent and severity of thrombocytopenia in vivax malaria and rule out this treatable condition in endemic areas with a high prevalence of other coexistent infections causing thrombocytopenia. |
| format | Article |
| id | doaj-art-93913ac2a0b34f5c9990ad3c3bd9dc3d |
| institution | DOAJ |
| issn | 0975-3605 2589-1235 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Marine Medical Society |
| spelling | doaj-art-93913ac2a0b34f5c9990ad3c3bd9dc3d2025-08-20T02:56:15ZengWolters Kluwer Medknow PublicationsJournal of Marine Medical Society0975-36052589-12352025-05-0127215515810.4103/jmms.jmms_97_24Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western RajasthanSudhir Sudhakar KhuneV S ShrikanthBiju M. JohnBackground: Malaria continues to be a major public health problem in India. Vivax malaria is being increasingly seen with thrombocytopenia. The reported prevalence of the same has been extremely variable and its significance is not well established. This study was conducted to ascertain the prevalence and severity of thrombocytopenia in vivax malaria and assess the outcome of cases with severe thrombocytopenia. A secondary objective was to compare the clinical and laboratory profile of cases of vivax malaria with falciparum malaria and mixed infection. Materials and Methods: This hospital-based prospective study was carried out in the department of general medicine at a sub-zonal hospital in Western Rajasthan in the year 2022. Consecutive febrile patients with a diagnosis of malaria were included in the study after ruling out coexistent alternate infections. Results: A total of 396 cases were enrolled. Ninety-nine percent of patients were male. The mean age of the study group was 32.1 years. A total of 328 (90.8%) out of 361 vivax malaria cases had thrombocytopenia (platelet count <150 × 103 μL) with 26.5% having severe thrombocytopenia (platelet count <50 × 103 μL). The mean defervescence duration was 44.4 h in vivax malaria. 3.4% of severe vivax malaria cases required intensive care unit care due to hypotension, respiratory distress, and multiorgan dysfunction, and none of them had any bleeding manifestations. All cases recovered well after standard treatment. There was a significant statistical difference between the mean platelet count among the three types of malaria: vivax, falciparum, and mixed (vivax + falciparum infections) (P = 0.03). Similarly, on applying Chi-square test, there was a significant difference in severe thrombocytopenia across the groups (P = 0.01). Conclusion: There is a high prevalence of thrombocytopenia in vivax malaria including severe thrombocytopenia. In the majority of cases, this thrombocytopenia does not result in any adverse event, and cases respond well to conventional treatment. Clinicians need to be aware of the extent and severity of thrombocytopenia in vivax malaria and rule out this treatable condition in endemic areas with a high prevalence of other coexistent infections causing thrombocytopenia.https://journals.lww.com/10.4103/jmms.jmms_97_24malariaplasmodium falciparumplasmodium vivaxthrombocytopenia |
| spellingShingle | Sudhir Sudhakar Khune V S Shrikanth Biju M. John Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan Journal of Marine Medical Society malaria plasmodium falciparum plasmodium vivax thrombocytopenia |
| title | Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan |
| title_full | Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan |
| title_fullStr | Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan |
| title_full_unstemmed | Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan |
| title_short | Thrombocytopenia in Plasmodium vivax Malaria: A Report from a Sub-zonal Hospital in Western Rajasthan |
| title_sort | thrombocytopenia in plasmodium vivax malaria a report from a sub zonal hospital in western rajasthan |
| topic | malaria plasmodium falciparum plasmodium vivax thrombocytopenia |
| url | https://journals.lww.com/10.4103/jmms.jmms_97_24 |
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