<p>Abstract</p> <p>Background</p> <p>Blood platelet levels are being evaluated as predictive and prognostic indicators of the severity of malaria infections in humans. However, there are few studies on platelets and <it>Plasmodium falciparum</it> malaria during pregnancy.</p> <p>Methods</p> <p>A case–control study was conducted at Gadarif Hospital in Eastern Sudan, an area characterized by unstable malaria transmission. The aim of the study was to investigate thrombocytopenia in pregnant women with <it>P. falciparum</it> malaria (cases) and healthy pregnant women (controls).</p> <p>Results</p> <p>The median (interquartile) platelet counts were significantly lower in patients with malaria (N = 60) than in the controls (N = 60), 61, 000 (43,000–85,000) vs. 249,000 (204,000–300,000)/μL, respectively, <it>p</it> < 0.001. However, there was no significant difference in the platelet counts in patients with severe <it>P. falciparum</it> malaria (N = 12) compared with those patients with uncomplicated <it>P. falciparum</it> malaria (N = 48), 68, 000 (33,000-88,000)/μL vs. 61, 000 (45,000<b>–</b>85,000)/μL, respectively, <it>p</it> = 0.8. While none of the control group had thrombocytopenia (platelet count <75, 000/μL), it was found that 6/12 (50%) and 27/48 (56.2%) (<it>p</it> <0.001) of the patients with severe malaria and uncomplicated malaria had thrombocytopenia, respectively. Pregnant women with <it>P. falciparum</it> malaria, compared with the pregnant healthy control group, were at higher risk (OR = 10.1, 95% CI = 4.1–25.18; <it>p</it> < 0.001) of thrombocytopenia. Two patients experienced bleeding, and there was one maternal death due to cerebral malaria where the patient’s platelet count was only 28,000/μL.</p> <p>Conclusion</p> <p><it>P. falciparum</it> malaria is associated with thrombocytopenia in pregnant women in this setting. More research is needed.</p
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